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Papers by Tripta Bhagat

Santosh University Journal of Health Sciences, Dec 31, 2022

International journal of contemporary surgery, Aug 3, 2021

The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh wa... more The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh was placedbetween peritoneum and abdominal wall or rectus muscle and posterior rectus sheath(9). The main advantageof pre peritoneal mesh repair are - Less chance of mesh infection and erosion through skin because thegraft lies in preperitoneal plane between posterior rectus sheath and peritoneum, avoids adhesions, bowelobstruction, enterocutaneous fistula and erosion of mesh, minimal morbidity and duration of hospitalstay is less compared to other techniques. The main disadvantage is it is more time consuming, extensivepreparation of preperitoneal plane and surgical experience. In our study 30 patients of incisional hernia weresubjected to preperitoneal mesh repair by Rive’s stoppa technique.It was found that there were :1. Less number of postoperative complications.2. No recurrence was noticed in this study.3. Preperitoneal mesh repair had excellent long-term results with minimal morbidity.As Compared withother types of mesh repair techniques (in literature), the preperitoneal mesh repair is the gold standardtreatment for incisional hernia repair.

Medico-Legal Update, 2012

International Surgery Journal, Feb 26, 2018

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallston... more Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications. Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded. Results: In present study adverse clinical factors only showed significant predictive value (p value-0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistically significant association. Age >50yrs, Male gender, radiological predictors (Thickened gall bladder wall, small contracted gall bladder, Single large impacted stone) and deranged LFT did not show significant predictive value. Conclusions: Clinical predictors are most reliable factors. Use of good clinical judgement regarding possibility of and likely difficulty along with understanding of available resources is important in making decision in each case.

International Surgery Journal, Jul 24, 2017

Background: Conventional open appendicectomy is a common emergency surgical procedure being used ... more Background: Conventional open appendicectomy is a common emergency surgical procedure being used for more than a century. Despite continuously increasing popularity of minimal access surgery, laparoscopic appendicectomy has not gained enough popularity. Methods: A prospective randomized study to compare laparoscopic and open appendicectomy for the treatment of appendicitis was carried out from April 2015 to October 2016. Thirty patients each were randomized to two groups. Decision to operate was taken on clinical grounds. Results: Twenty-five patients in each group were confirmed to be suffering from appendicitis. While alternative diagnosis could be established in 4 out of remaining 5 patients in laparoscopic group, in only 1 out of 5 patients from open appendicectomy definitive diagnosis for pain could be established. There was no significant difference in operative time between two groups. Patients in laparoscopic group had lesser postoperative pain scores and wound complications. They also got discharged and returned to normal activity earlier than those in open appendicectomy group. Conclusions: Laparoscopic appendicectomy has lesser postoperative morbidity and improves diagnosis in nonappendicitis patients.

Surgical site infection is common in post operative patients. Some of the complications are redne... more Surgical site infection is common in post operative patients. Some of the complications are redness and pain at the site of closure, fever, wound necrosis, collection, wound dehiscence and scar. Skin closure by metallic staplers is quick method of skin approximation. It reduces closure time by half in comparison to Ethilon suture. The scar of staplers is comparatively better than suture. Introduction Every year several millions of women undergo caesarean section. As a result of that they acquire an abdominal scar. Nowadays women of all ages place extreme importance on the appearance of the scar in addition to the symptoms of pain, tenderness and itching. An aesthetically poor scar can have a negative impact on the overall quality of life causing considerable distress, loss of self-esteem and unhappiness. (1,2) The outcome of the surgical skin closure is influenced by the indication of the procedure, the location of the surgical site and the associated intra-operative or post-operati...

International journal of contemporary surgery, 2021

The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh wa... more The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh was placedbetween peritoneum and abdominal wall or rectus muscle and posterior rectus sheath(9). The main advantageof pre peritoneal mesh repair are - Less chance of mesh infection and erosion through skin because thegraft lies in preperitoneal plane between posterior rectus sheath and peritoneum, avoids adhesions, bowelobstruction, enterocutaneous fistula and erosion of mesh, minimal morbidity and duration of hospitalstay is less compared to other techniques. The main disadvantage is it is more time consuming, extensivepreparation of preperitoneal plane and surgical experience. In our study 30 patients of incisional hernia weresubjected to preperitoneal mesh repair by Rive’s stoppa technique.It was found that there were :1. Less number of postoperative complications.2. No recurrence was noticed in this study.3. Preperitoneal mesh repair had excellent long-term results with minimal morbidi...

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Vulval lymphangiectasia is a rare cutaneous condition of lymphatic channels in deep dermal and su... more Vulval lymphangiectasia is a rare cutaneous condition of lymphatic channels in deep dermal and subcutaneous layers. It can be congenital condition or might develop secondary to tuberculosis, surgery, radiotherapy, crohn’s disease etc. Very few cases have been reported in the literature so far. Diagnosis is mainly clinical aided with histopathology. Various treatment modalities are available for this condition. Surgical treatment is the most commonly used method to treat vulvar lymphangiectasia and has offered promising results. In this report, we present 2 cases of vulval lymphangiectasia- one congenital case and other acquired after tuberculosis.

Scottish Medical Journal, 2006

Background and Aims To assess the benefits of laparoscopic nephrectomy in children as compared to... more Background and Aims To assess the benefits of laparoscopic nephrectomy in children as compared to open surgery and to ascertain whether or not the retroperitoneal technique offers any surgical advantage over the transperitoneal approach. Methods and Results This study gathered retrospective data on a consecutive series of 51 paediatric patients comparing; operative time, length of hospital stay and analgesic requirement. Results show that when laparoscopic surgery is compared with the open technique it took 25 mins longer to perform, there was a shorter post operative stay by 2.5 days, and a 50% reduction in morphine use. Patients who had the retroperitoneal technique were discharged from hospital within one day. Conclusions Compared to previous studies, the findings in this study suggest that there are distinct benefits in laparoscopy for children. There is some evidence in favour of the retroperitoneal technique. Patients are in hospital for shorter periods and need less analgesia.

Journal of Gastroenterology, 2002

Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duc... more Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.

Santosh University Journal of Health Sciences

The International Journal of Lower Extremity Wounds

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large prop... more Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in ...

Santosh University Journal of Health Sciences, 2021

Squamous cell carcinoma (SCC) of the oral cavity is the most common site of head-and-neck carcino... more Squamous cell carcinoma (SCC) of the oral cavity is the most common site of head-and-neck carcinoma in India. It grows in the vicinity and penetrates through adjacent anatomical structures; surgical resection of the tumor becomes more challenging in the head-and-neck region. As important anatomical structures are closely packed and to resect the tumor with safe margins being an issue, thus raising specific considerations for reconstruction relative to the extent of resection. The present case describes the management of a 64-year-old man with SCC of the left buccal mucosa, invaded into the skin of the cheek. It was managed surgically, with resection and flap reconstruction in the same sitting done in Santosh Medical College and Hospital, Ghaziabad.

National Journal of Laboratory Medicine, 2015

Cutaneous horn (Cornu cutaneum), is a hard, projectile lesion developing from an unusual accumula... more Cutaneous horn (Cornu cutaneum), is a hard, projectile lesion developing from an unusual accumulation of keratin. The base of the horn may be flat, nodular or crateriform. Usually a cutaneous horn is several millimeters long. Histologically, there is a greatly thickened stratum corneum with scattered areas of parakeratosis. The lesion can originate from a variety of skin conditions ranging from benign to premalignant and malignant. Malignant lesions at the base of the horn usually are squamous cell carcinoma, although other carcinomas have been reported. When a Cutaneous horn has a larger base than its height, chances of malignancy are increased. Cutaneous horns are common in Caucasians but rare in Asians and Africans. A case of a facial cutaneous horn in an old lady is being presented here, which, despite having an ominous appearance was found to be benign. Conversely, a lesion with benign appearance may be harbouring malignancy implying that appearance of lesion may be deceptive. ...

Euroasian Journal of Hepato-Gastroenterology, 2017

Porcelain gallbladder or calcified gallbladder is a rare entity and is considered as the end stag... more Porcelain gallbladder or calcified gallbladder is a rare entity and is considered as the end stage of chronic cholecystitis. This disease is rarely diagnosed preoperatively and usually mimics carcinoma gallbladder. Hereby, we present a rare and interesting case of porcelain gallbladder that was diagnosed preoperatively and managed by cholecystectomy. How to cite this article: Goel A, Agarwal A, Gupta S, Bhagat TS, Kumar G, Gupta AK. Porcelain Gallbladder. Euroasian J Hepato-Gastroenterol 2017;7(2):181-182.

International Surgery Journal, 2018

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallston... more Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications.Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded.Results: In present study adverse clinical factors only showed significant predictive value (p value - 0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistical...

Santosh University Journal of Health Sciences, 2020

Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives... more Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives: This study aims to find out the clinical and epidemiology profile of acute abdominal pain among patients attending emergency department of Santosh Medical College Ghaziabad. Materials and Methods: A tertiary care hospital based, cross-sectional study was conducted from January 2018-April 2019 2018, among patients presenting with acute abdominal pain to Santosh Medical College Ghaziabad, India. Data was entered on a standard data collection sheet after obtaining a written informed consent. Results: Out of 1200 patients admitted via the Emergency Department at the Hospital, 200 (16.6%) were admitted with atraumatic acute abdominal pain. Out of 200, 120(60%) were due to Surgical causes and 80 due to non-surgical causes. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Acute cholecystitis was the most common etiology of acute abdominal pain (35.8% cases), followed by, Renal Stones (30.5%), Acute Appendicitis (17.5%) and Intestinal Obstruction (16.67%) respectively. Conclusion: About 16.60% of all emergency admissions were due to acute abdominal pain and about 60.0% of all atraumatic acute abdominal pain was due to surgical cause. Acute cholecystitis was the most common cause of surgical abdominal pain.

Euroasian Journal of Hepato-Gastroenterology, 2019

Background: Laparoscopic cholecystectomy is the gold standard procedure for cholelithiasis. Pneum... more Background: Laparoscopic cholecystectomy is the gold standard procedure for cholelithiasis. Pneumoperitoneum is created using carbon dioxide (CO 2) , which is usually maintained at a range of 12-14 mm Hg. An emerging trend has been the use of low-pressure pneumoperitoneum in the range of 7-10 mm Hg in an attempt to lower the impact of pneumoperitoneum on the human physiology while providing adequate working space. Our study proposes to compare the effects of low-pressure pneumoperitoneum with the use of standard pressure of pneumoperitoneum. Aims and objective: To compare and analyze various factors like blood pressure, heart rate, end-tidal CO 2 and postoperative shoulder tip pain in cases undergoing laparoscopic cholecystectomy using standard pressure versus low pressure. Materials and methods: This is a prospective randomized study carried out at Santosh Medical College and Hospitals, Ghaziabad from September 2017 to December 2018. This study included 60 patients of cholelithiasis which were divided into two groups of 30 patients each. Group I was offered laparoscopic cholecystectomy under standard pressure pneumoperitoneum and group II underwent laparoscopic cholecystectomy using low-pressure pneumoperitoneum. Patients in each group were evaluated for various intraoperative physiological changes and postoperative shoulder tip pain. Observations and results: Cholelithiasis is commonly seen in middle-aged females. There is no significant difference in duration of surgery between the two groups. However, various factors like systolic blood pressure, heart rate, end-tidal CO 2 were significantly better in the lowpressure group. Postoperative shoulder tip pain (measured by VAS scoring system) was significantly less in the low-pressure group during the first 24 hours. Conclusion: Laparoscopic cholecystectomy under low-pressure pneumoperitoneum causes minimal physiological changes and less postoperative shoulder tip pain.

Santosh University Journal of Health Sciences, Dec 31, 2022

International journal of contemporary surgery, Aug 3, 2021

The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh wa... more The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh was placedbetween peritoneum and abdominal wall or rectus muscle and posterior rectus sheath(9). The main advantageof pre peritoneal mesh repair are - Less chance of mesh infection and erosion through skin because thegraft lies in preperitoneal plane between posterior rectus sheath and peritoneum, avoids adhesions, bowelobstruction, enterocutaneous fistula and erosion of mesh, minimal morbidity and duration of hospitalstay is less compared to other techniques. The main disadvantage is it is more time consuming, extensivepreparation of preperitoneal plane and surgical experience. In our study 30 patients of incisional hernia weresubjected to preperitoneal mesh repair by Rive’s stoppa technique.It was found that there were :1. Less number of postoperative complications.2. No recurrence was noticed in this study.3. Preperitoneal mesh repair had excellent long-term results with minimal morbidity.As Compared withother types of mesh repair techniques (in literature), the preperitoneal mesh repair is the gold standardtreatment for incisional hernia repair.

Medico-Legal Update, 2012

International Surgery Journal, Feb 26, 2018

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallston... more Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications. Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded. Results: In present study adverse clinical factors only showed significant predictive value (p value-0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistically significant association. Age >50yrs, Male gender, radiological predictors (Thickened gall bladder wall, small contracted gall bladder, Single large impacted stone) and deranged LFT did not show significant predictive value. Conclusions: Clinical predictors are most reliable factors. Use of good clinical judgement regarding possibility of and likely difficulty along with understanding of available resources is important in making decision in each case.

International Surgery Journal, Jul 24, 2017

Background: Conventional open appendicectomy is a common emergency surgical procedure being used ... more Background: Conventional open appendicectomy is a common emergency surgical procedure being used for more than a century. Despite continuously increasing popularity of minimal access surgery, laparoscopic appendicectomy has not gained enough popularity. Methods: A prospective randomized study to compare laparoscopic and open appendicectomy for the treatment of appendicitis was carried out from April 2015 to October 2016. Thirty patients each were randomized to two groups. Decision to operate was taken on clinical grounds. Results: Twenty-five patients in each group were confirmed to be suffering from appendicitis. While alternative diagnosis could be established in 4 out of remaining 5 patients in laparoscopic group, in only 1 out of 5 patients from open appendicectomy definitive diagnosis for pain could be established. There was no significant difference in operative time between two groups. Patients in laparoscopic group had lesser postoperative pain scores and wound complications. They also got discharged and returned to normal activity earlier than those in open appendicectomy group. Conclusions: Laparoscopic appendicectomy has lesser postoperative morbidity and improves diagnosis in nonappendicitis patients.

Surgical site infection is common in post operative patients. Some of the complications are redne... more Surgical site infection is common in post operative patients. Some of the complications are redness and pain at the site of closure, fever, wound necrosis, collection, wound dehiscence and scar. Skin closure by metallic staplers is quick method of skin approximation. It reduces closure time by half in comparison to Ethilon suture. The scar of staplers is comparatively better than suture. Introduction Every year several millions of women undergo caesarean section. As a result of that they acquire an abdominal scar. Nowadays women of all ages place extreme importance on the appearance of the scar in addition to the symptoms of pain, tenderness and itching. An aesthetically poor scar can have a negative impact on the overall quality of life causing considerable distress, loss of self-esteem and unhappiness. (1,2) The outcome of the surgical skin closure is influenced by the indication of the procedure, the location of the surgical site and the associated intra-operative or post-operati...

International journal of contemporary surgery, 2021

The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh wa... more The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh was placedbetween peritoneum and abdominal wall or rectus muscle and posterior rectus sheath(9). The main advantageof pre peritoneal mesh repair are - Less chance of mesh infection and erosion through skin because thegraft lies in preperitoneal plane between posterior rectus sheath and peritoneum, avoids adhesions, bowelobstruction, enterocutaneous fistula and erosion of mesh, minimal morbidity and duration of hospitalstay is less compared to other techniques. The main disadvantage is it is more time consuming, extensivepreparation of preperitoneal plane and surgical experience. In our study 30 patients of incisional hernia weresubjected to preperitoneal mesh repair by Rive’s stoppa technique.It was found that there were :1. Less number of postoperative complications.2. No recurrence was noticed in this study.3. Preperitoneal mesh repair had excellent long-term results with minimal morbidi...

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Vulval lymphangiectasia is a rare cutaneous condition of lymphatic channels in deep dermal and su... more Vulval lymphangiectasia is a rare cutaneous condition of lymphatic channels in deep dermal and subcutaneous layers. It can be congenital condition or might develop secondary to tuberculosis, surgery, radiotherapy, crohn’s disease etc. Very few cases have been reported in the literature so far. Diagnosis is mainly clinical aided with histopathology. Various treatment modalities are available for this condition. Surgical treatment is the most commonly used method to treat vulvar lymphangiectasia and has offered promising results. In this report, we present 2 cases of vulval lymphangiectasia- one congenital case and other acquired after tuberculosis.

Scottish Medical Journal, 2006

Background and Aims To assess the benefits of laparoscopic nephrectomy in children as compared to... more Background and Aims To assess the benefits of laparoscopic nephrectomy in children as compared to open surgery and to ascertain whether or not the retroperitoneal technique offers any surgical advantage over the transperitoneal approach. Methods and Results This study gathered retrospective data on a consecutive series of 51 paediatric patients comparing; operative time, length of hospital stay and analgesic requirement. Results show that when laparoscopic surgery is compared with the open technique it took 25 mins longer to perform, there was a shorter post operative stay by 2.5 days, and a 50% reduction in morphine use. Patients who had the retroperitoneal technique were discharged from hospital within one day. Conclusions Compared to previous studies, the findings in this study suggest that there are distinct benefits in laparoscopy for children. There is some evidence in favour of the retroperitoneal technique. Patients are in hospital for shorter periods and need less analgesia.

Journal of Gastroenterology, 2002

Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duc... more Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.

Santosh University Journal of Health Sciences

The International Journal of Lower Extremity Wounds

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large prop... more Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in ...

Santosh University Journal of Health Sciences, 2021

Squamous cell carcinoma (SCC) of the oral cavity is the most common site of head-and-neck carcino... more Squamous cell carcinoma (SCC) of the oral cavity is the most common site of head-and-neck carcinoma in India. It grows in the vicinity and penetrates through adjacent anatomical structures; surgical resection of the tumor becomes more challenging in the head-and-neck region. As important anatomical structures are closely packed and to resect the tumor with safe margins being an issue, thus raising specific considerations for reconstruction relative to the extent of resection. The present case describes the management of a 64-year-old man with SCC of the left buccal mucosa, invaded into the skin of the cheek. It was managed surgically, with resection and flap reconstruction in the same sitting done in Santosh Medical College and Hospital, Ghaziabad.

National Journal of Laboratory Medicine, 2015

Cutaneous horn (Cornu cutaneum), is a hard, projectile lesion developing from an unusual accumula... more Cutaneous horn (Cornu cutaneum), is a hard, projectile lesion developing from an unusual accumulation of keratin. The base of the horn may be flat, nodular or crateriform. Usually a cutaneous horn is several millimeters long. Histologically, there is a greatly thickened stratum corneum with scattered areas of parakeratosis. The lesion can originate from a variety of skin conditions ranging from benign to premalignant and malignant. Malignant lesions at the base of the horn usually are squamous cell carcinoma, although other carcinomas have been reported. When a Cutaneous horn has a larger base than its height, chances of malignancy are increased. Cutaneous horns are common in Caucasians but rare in Asians and Africans. A case of a facial cutaneous horn in an old lady is being presented here, which, despite having an ominous appearance was found to be benign. Conversely, a lesion with benign appearance may be harbouring malignancy implying that appearance of lesion may be deceptive. ...

Euroasian Journal of Hepato-Gastroenterology, 2017

Porcelain gallbladder or calcified gallbladder is a rare entity and is considered as the end stag... more Porcelain gallbladder or calcified gallbladder is a rare entity and is considered as the end stage of chronic cholecystitis. This disease is rarely diagnosed preoperatively and usually mimics carcinoma gallbladder. Hereby, we present a rare and interesting case of porcelain gallbladder that was diagnosed preoperatively and managed by cholecystectomy. How to cite this article: Goel A, Agarwal A, Gupta S, Bhagat TS, Kumar G, Gupta AK. Porcelain Gallbladder. Euroasian J Hepato-Gastroenterol 2017;7(2):181-182.

International Surgery Journal, 2018

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallston... more Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications.Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded.Results: In present study adverse clinical factors only showed significant predictive value (p value - 0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistical...

Santosh University Journal of Health Sciences, 2020

Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives... more Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives: This study aims to find out the clinical and epidemiology profile of acute abdominal pain among patients attending emergency department of Santosh Medical College Ghaziabad. Materials and Methods: A tertiary care hospital based, cross-sectional study was conducted from January 2018-April 2019 2018, among patients presenting with acute abdominal pain to Santosh Medical College Ghaziabad, India. Data was entered on a standard data collection sheet after obtaining a written informed consent. Results: Out of 1200 patients admitted via the Emergency Department at the Hospital, 200 (16.6%) were admitted with atraumatic acute abdominal pain. Out of 200, 120(60%) were due to Surgical causes and 80 due to non-surgical causes. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Acute cholecystitis was the most common etiology of acute abdominal pain (35.8% cases), followed by, Renal Stones (30.5%), Acute Appendicitis (17.5%) and Intestinal Obstruction (16.67%) respectively. Conclusion: About 16.60% of all emergency admissions were due to acute abdominal pain and about 60.0% of all atraumatic acute abdominal pain was due to surgical cause. Acute cholecystitis was the most common cause of surgical abdominal pain.

Euroasian Journal of Hepato-Gastroenterology, 2019

Background: Laparoscopic cholecystectomy is the gold standard procedure for cholelithiasis. Pneum... more Background: Laparoscopic cholecystectomy is the gold standard procedure for cholelithiasis. Pneumoperitoneum is created using carbon dioxide (CO 2) , which is usually maintained at a range of 12-14 mm Hg. An emerging trend has been the use of low-pressure pneumoperitoneum in the range of 7-10 mm Hg in an attempt to lower the impact of pneumoperitoneum on the human physiology while providing adequate working space. Our study proposes to compare the effects of low-pressure pneumoperitoneum with the use of standard pressure of pneumoperitoneum. Aims and objective: To compare and analyze various factors like blood pressure, heart rate, end-tidal CO 2 and postoperative shoulder tip pain in cases undergoing laparoscopic cholecystectomy using standard pressure versus low pressure. Materials and methods: This is a prospective randomized study carried out at Santosh Medical College and Hospitals, Ghaziabad from September 2017 to December 2018. This study included 60 patients of cholelithiasis which were divided into two groups of 30 patients each. Group I was offered laparoscopic cholecystectomy under standard pressure pneumoperitoneum and group II underwent laparoscopic cholecystectomy using low-pressure pneumoperitoneum. Patients in each group were evaluated for various intraoperative physiological changes and postoperative shoulder tip pain. Observations and results: Cholelithiasis is commonly seen in middle-aged females. There is no significant difference in duration of surgery between the two groups. However, various factors like systolic blood pressure, heart rate, end-tidal CO 2 were significantly better in the lowpressure group. Postoperative shoulder tip pain (measured by VAS scoring system) was significantly less in the low-pressure group during the first 24 hours. Conclusion: Laparoscopic cholecystectomy under low-pressure pneumoperitoneum causes minimal physiological changes and less postoperative shoulder tip pain.