mohit sharma - Academia.edu (original) (raw)

Papers by mohit sharma

Craniomaxillofacial Trauma and Reconstruction, 2013

Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction w... more Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction with free flaps after maxillectomy. Methods This was a retrospective analysis of 34 consecutive patients who underwent maxillectomy with orbital floor removal for malignancies, reconstructed with free flaps. A cross-sectional survey to assess the functional and esthetic outcome was done in 28 patients who were alive and disease-free, with a minimum of 6 months of follow-up. Results Twenty-six patients had bony reconstruction, and eight had soft tissue reconstruction. Free fibula flap was the commonest flap used (n = 14). Visual acuity was normal in 86%. Eye movements were normal in 92%. Abnormal globe position resulted in nine patients. Esthetic satisfaction was good in 19 patients (68%). Though there was no statistically significant difference in outcome of visual acuity, eye movement, and patient esthetic satisfaction between patients with bony and soft tissue reconstruction, more patients without bony reconstruction had abnormal globe position (p = 0.040). Conclusion Free tissue transfer has improved the results of orbital floor reconstruction after total maxillectomy, preserving the eye. Good functional and esthetic outcome was achieved. Though our study favors a bony orbital reconstruction, a larger study with adequate power and equal distribution of patients among the groups would be needed to determine this. Free fibula flap remains the commonest choice when a bony reconstruction is contemplated.

Indian Journal of Plant Physiology, 2014

Your article is protected by copyright and all rights are held exclusively by Indian Society for ... more Your article is protected by copyright and all rights are held exclusively by Indian Society for Plant Physiology. This e-offprint is for personal use only and shall not be selfarchived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com".

Prehospital and Disaster Medicine, 2014

India is the second most populous country in the world. Currently, India does not have a centrali... more India is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.

Journal of Surgical Technique and Case Report, 2012

After resection of the tumors of oral cavity adjacent to the mandible, it is a common situation t... more After resection of the tumors of oral cavity adjacent to the mandible, it is a common situation that the whole of one side of the gingival mucosal segment has to be stripped off the mandible to get an adequate margin. When a cutaneous flap is used for reconstruction, it has to be hitched to the teeth to get a watertight seal. We describe a technique to hitch the flap to the adjacent teeth in such an instance. The technique was applied in 10 patients with oral cancer, resected, and reconstructed with cutaneous flaps. The technique was found to be effective in all 10 patients. Adequate seal was obtained in all patients. Oral diet was started within 7 days. An effective and simple technique to approximate a cutaneous flap to the teeth-bearing mandible, when all the mucosa is removed as part of oncological resection, is reported.

Journal of Reconstructive Microsurgery, 2013

Indian Journal of Plastic Surgery, 2009

A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fasci... more A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome.

Indian Journal of Plastic Surgery, 2013

Adequate drainage of venous blood is the most critical part of successful free tissue transfer. W... more Adequate drainage of venous blood is the most critical part of successful free tissue transfer. We report a case of anterolateral thigh flap used for covering open communited tibial fracture. The flap was salvaged with short term augmentation of venous drainage with external shunt. The drainage was continued for six days. It was confirmed that there is no more congestion after blocking the catheter and then the drainage was discontinued on seventh day. The flap was successfully salvaged. This method has potential applications in multiple situations for successful salvage of free tissue transfer.

Indian Journal of Plastic Surgery, 2013

Most surgical patients end up with a scar and most of these would want at least some improvement ... more Most surgical patients end up with a scar and most of these would want at least some improvement in the appearance of the scar. Using sound techniques for wound closure surgeons can, to a certain extent, prevent suboptimal scars. This article reviews the principles of prevention and treatment of suboptimal scars. Surgical techniques of scar revision, i.e., Z plasty, W plasty, and geometrical broken line closure are described. Post-operative care and other adjuvant therapies of scars are described. A short description of dermabrasion and lasers for management of scars is given. It is hoped that this review helps the surgeon to formulate a comprehensive plan for management of scars of these patients.

Indian Journal of Plastic Surgery, 2012

Indian Journal of Plastic Surgery, 2011

Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular t... more Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular tissue. The type of surgery chosen depends on the grade of the condition. Because gynaecomastia is treated primarily as a cosmetic procedure, we aimed at reducing the invasiveness of the surgery. The technique complies with all recommended protocols for different grades of gynaecomastia. It uses liposuction, gland excision, or both, leaving only minimal post-operative scars. The use of cross-chest liposuction through incisions on the edge of the areola helps to get rid of all the fat under the areola without an additional scar as in the conventional method. This is a short series of 20 patients, all with bilateral gynaecomastia (i.e., 40 breasts), belonging to Simon's Stage 1 and 2, studied over a period of 2 years. The average period of follow-up was 15 months. Post-operative complications were reported in only two cases, with none showing long-term complications or issues specifically due to the procedure. Cross-chest liposuction for gynaecomastia is a simple yet effective surgical tool in bilateral gynaecomastia treatment to decrease the post-operative scars. The use of techniques like incision line drain placement and post-drain removal suturing of wounds aid in decreasing the scar.

Journal of Surgical Oncology, 2009

Free flaps are being widely used for reconstruction of defects following head and neck cancer abl... more Free flaps are being widely used for reconstruction of defects following head and neck cancer ablation. The pedicle of the flap is usually tunneled into the neck wound for anastomosis to the neck vessels. This transfer of the pedicle can be technically difficult to execute and associated with difficulties of torsion and kinking. No effective method has been so far reported to make this procedure easy and safe. A very easy and effective method for the pedicle transfer is described in this report, which has been practiced successfully in our head and neck service in more than 175 free flaps. J. Surg. Oncol. 2009;99:80–81. © 2008 Wiley-Liss, Inc.

Contemporary Clinical Dentistry, 2010

The aim of this study was to evaluate the in vitro effect of various obturating materials on frac... more The aim of this study was to evaluate the in vitro effect of various obturating materials on fracture resistance of root canal treated teeth. Sixty freshly extracted human mandibular premolars were used. After standardizing the length to 13 mm, the teeth were biomechanically prepared and divided into four groups based on type of obturating materials used. Teeth were embedded in acrylic resin and fracture strength was measured using a universal testing machine. Data obtained was evaluated statistically using one-way ANOVA and the unpaired t-test. Teeth obturated with AH Plus and gutta percha showed higher fracture resistance than those obturated with Resilon-Epiphany. The results suggested that the group obturated with gutta percha and zinc oxide-eugenol sealer had the lowest fracture resistance. No statistically significant difference was found between the unobturated (control) group and the zinc oxide-eugenol group.

Clinical & Experimental Metastasis, 2009

Bone is one of the most frequent sites for metastasis of breast and prostate cancers. Bone metast... more Bone is one of the most frequent sites for metastasis of breast and prostate cancers. Bone metastases are associated with pathologic changes in bone turnover and severe pain. The mechanisms that trigger these effects are not well understood, but it is postulated that tumour cells release factors which interfere with signalling processes critical to bone homeostasis. We have identified that several cancer cell lines known to cause bone disruption in animal models of bone metastasis appear to secrete glutamate into their extracellular environment in vitro. Although these cells also express specific glutamate receptors, the implications of this potentially disruptive chemical signal are discussed in relation to normal glutamate-dependent communication processes in bone and a possible mechanistic connection is made between tumour cell glutamate release and the development of pathological changes in bone turnover.

Canadian Journal of Physiology and Pharmacology, 2010

Glutamatergic intercellular communication is involved in many aspects of metabolic homeostasis in... more Glutamatergic intercellular communication is involved in many aspects of metabolic homeostasis in normal bone. In bone metastasis, the balance between bone formation and degradation is disrupted. Although the responsible mechanisms are not clear, we have previously identified that cancer cell lines used in bone tumour models secrete glutamate, suggesting that tumour-derived glutamate may disrupt sensitive signalling systems in bone. This study examines the role of glutamate in mature osteoclastic bone resorption, osteoblast differentiation, and bone nodule formation. Glutamate was found to have no effect on the survival or activity of mature osteoclasts, although glutamate transporter inhibition and receptor blockade increased the number of bone resorption pits. Furthermore, transporter inhibition increased the area of resorbed bone while significantly decreasing the number of osteoclasts. Alkaline phosphatase activity and extracellular matrix mineralization were used as measurements of osteoblast differentiation. Glutamate significantly increased osteoblast differentiation and mineralization, but transport inhibitors had no effect. These studies support earlier findings suggesting that glutamate may be more important for osteoclastogenesis than for osteoclast proliferation or functions. Since glutamate is capable of changing the differentiation and activities of both osteoclast and osteoblast cell types in bone, it is reasonable to postulate that tumour-derived glutamate may impact bone homeostasis in bone metastasis.

Biochemical and Biophysical Research Communications, 2010

Although the amino acid glutamate is used as an intercellular signaling molecule for normal bone ... more Although the amino acid glutamate is used as an intercellular signaling molecule for normal bone homeostasis, little is known regarding its possible role in the metabolic disruption characteristic of bone metastasis. We have previously shown in vitro that cancer cell lines relevant to bone metastasis release glutamate into the extracellular environment. This study demonstrates the expression of multiple glutamate transporters in cancer cell lines of non-central nervous system origin. Furthermore, we identify the molecular mechanism responsible for glutamate export and show that this system can be inhibited pharmacologically. By highlighting that glutamate secretion is a common biological feature of cancer cells, this study suggests that tumor-derived glutamate could interfere with glutamate-dependent intercellular signaling in normal bone. Pharmacological interference with cancer cell glutamate release may be a viable option for limiting host bone response to invading tumor cells in bone metastasis.

Craniomaxillofacial Trauma and Reconstruction, 2013

Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction w... more Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction with free flaps after maxillectomy. Methods This was a retrospective analysis of 34 consecutive patients who underwent maxillectomy with orbital floor removal for malignancies, reconstructed with free flaps. A cross-sectional survey to assess the functional and esthetic outcome was done in 28 patients who were alive and disease-free, with a minimum of 6 months of follow-up. Results Twenty-six patients had bony reconstruction, and eight had soft tissue reconstruction. Free fibula flap was the commonest flap used (n = 14). Visual acuity was normal in 86%. Eye movements were normal in 92%. Abnormal globe position resulted in nine patients. Esthetic satisfaction was good in 19 patients (68%). Though there was no statistically significant difference in outcome of visual acuity, eye movement, and patient esthetic satisfaction between patients with bony and soft tissue reconstruction, more patients without bony reconstruction had abnormal globe position (p = 0.040). Conclusion Free tissue transfer has improved the results of orbital floor reconstruction after total maxillectomy, preserving the eye. Good functional and esthetic outcome was achieved. Though our study favors a bony orbital reconstruction, a larger study with adequate power and equal distribution of patients among the groups would be needed to determine this. Free fibula flap remains the commonest choice when a bony reconstruction is contemplated.

Indian Journal of Plant Physiology, 2014

Your article is protected by copyright and all rights are held exclusively by Indian Society for ... more Your article is protected by copyright and all rights are held exclusively by Indian Society for Plant Physiology. This e-offprint is for personal use only and shall not be selfarchived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com".

Prehospital and Disaster Medicine, 2014

India is the second most populous country in the world. Currently, India does not have a centrali... more India is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.

Journal of Surgical Technique and Case Report, 2012

After resection of the tumors of oral cavity adjacent to the mandible, it is a common situation t... more After resection of the tumors of oral cavity adjacent to the mandible, it is a common situation that the whole of one side of the gingival mucosal segment has to be stripped off the mandible to get an adequate margin. When a cutaneous flap is used for reconstruction, it has to be hitched to the teeth to get a watertight seal. We describe a technique to hitch the flap to the adjacent teeth in such an instance. The technique was applied in 10 patients with oral cancer, resected, and reconstructed with cutaneous flaps. The technique was found to be effective in all 10 patients. Adequate seal was obtained in all patients. Oral diet was started within 7 days. An effective and simple technique to approximate a cutaneous flap to the teeth-bearing mandible, when all the mucosa is removed as part of oncological resection, is reported.

Journal of Reconstructive Microsurgery, 2013

Indian Journal of Plastic Surgery, 2009

A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fasci... more A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome.

Indian Journal of Plastic Surgery, 2013

Adequate drainage of venous blood is the most critical part of successful free tissue transfer. W... more Adequate drainage of venous blood is the most critical part of successful free tissue transfer. We report a case of anterolateral thigh flap used for covering open communited tibial fracture. The flap was salvaged with short term augmentation of venous drainage with external shunt. The drainage was continued for six days. It was confirmed that there is no more congestion after blocking the catheter and then the drainage was discontinued on seventh day. The flap was successfully salvaged. This method has potential applications in multiple situations for successful salvage of free tissue transfer.

Indian Journal of Plastic Surgery, 2013

Most surgical patients end up with a scar and most of these would want at least some improvement ... more Most surgical patients end up with a scar and most of these would want at least some improvement in the appearance of the scar. Using sound techniques for wound closure surgeons can, to a certain extent, prevent suboptimal scars. This article reviews the principles of prevention and treatment of suboptimal scars. Surgical techniques of scar revision, i.e., Z plasty, W plasty, and geometrical broken line closure are described. Post-operative care and other adjuvant therapies of scars are described. A short description of dermabrasion and lasers for management of scars is given. It is hoped that this review helps the surgeon to formulate a comprehensive plan for management of scars of these patients.

Indian Journal of Plastic Surgery, 2012

Indian Journal of Plastic Surgery, 2011

Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular t... more Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular tissue. The type of surgery chosen depends on the grade of the condition. Because gynaecomastia is treated primarily as a cosmetic procedure, we aimed at reducing the invasiveness of the surgery. The technique complies with all recommended protocols for different grades of gynaecomastia. It uses liposuction, gland excision, or both, leaving only minimal post-operative scars. The use of cross-chest liposuction through incisions on the edge of the areola helps to get rid of all the fat under the areola without an additional scar as in the conventional method. This is a short series of 20 patients, all with bilateral gynaecomastia (i.e., 40 breasts), belonging to Simon's Stage 1 and 2, studied over a period of 2 years. The average period of follow-up was 15 months. Post-operative complications were reported in only two cases, with none showing long-term complications or issues specifically due to the procedure. Cross-chest liposuction for gynaecomastia is a simple yet effective surgical tool in bilateral gynaecomastia treatment to decrease the post-operative scars. The use of techniques like incision line drain placement and post-drain removal suturing of wounds aid in decreasing the scar.

Journal of Surgical Oncology, 2009

Free flaps are being widely used for reconstruction of defects following head and neck cancer abl... more Free flaps are being widely used for reconstruction of defects following head and neck cancer ablation. The pedicle of the flap is usually tunneled into the neck wound for anastomosis to the neck vessels. This transfer of the pedicle can be technically difficult to execute and associated with difficulties of torsion and kinking. No effective method has been so far reported to make this procedure easy and safe. A very easy and effective method for the pedicle transfer is described in this report, which has been practiced successfully in our head and neck service in more than 175 free flaps. J. Surg. Oncol. 2009;99:80–81. © 2008 Wiley-Liss, Inc.

Contemporary Clinical Dentistry, 2010

The aim of this study was to evaluate the in vitro effect of various obturating materials on frac... more The aim of this study was to evaluate the in vitro effect of various obturating materials on fracture resistance of root canal treated teeth. Sixty freshly extracted human mandibular premolars were used. After standardizing the length to 13 mm, the teeth were biomechanically prepared and divided into four groups based on type of obturating materials used. Teeth were embedded in acrylic resin and fracture strength was measured using a universal testing machine. Data obtained was evaluated statistically using one-way ANOVA and the unpaired t-test. Teeth obturated with AH Plus and gutta percha showed higher fracture resistance than those obturated with Resilon-Epiphany. The results suggested that the group obturated with gutta percha and zinc oxide-eugenol sealer had the lowest fracture resistance. No statistically significant difference was found between the unobturated (control) group and the zinc oxide-eugenol group.

Clinical & Experimental Metastasis, 2009

Bone is one of the most frequent sites for metastasis of breast and prostate cancers. Bone metast... more Bone is one of the most frequent sites for metastasis of breast and prostate cancers. Bone metastases are associated with pathologic changes in bone turnover and severe pain. The mechanisms that trigger these effects are not well understood, but it is postulated that tumour cells release factors which interfere with signalling processes critical to bone homeostasis. We have identified that several cancer cell lines known to cause bone disruption in animal models of bone metastasis appear to secrete glutamate into their extracellular environment in vitro. Although these cells also express specific glutamate receptors, the implications of this potentially disruptive chemical signal are discussed in relation to normal glutamate-dependent communication processes in bone and a possible mechanistic connection is made between tumour cell glutamate release and the development of pathological changes in bone turnover.

Canadian Journal of Physiology and Pharmacology, 2010

Glutamatergic intercellular communication is involved in many aspects of metabolic homeostasis in... more Glutamatergic intercellular communication is involved in many aspects of metabolic homeostasis in normal bone. In bone metastasis, the balance between bone formation and degradation is disrupted. Although the responsible mechanisms are not clear, we have previously identified that cancer cell lines used in bone tumour models secrete glutamate, suggesting that tumour-derived glutamate may disrupt sensitive signalling systems in bone. This study examines the role of glutamate in mature osteoclastic bone resorption, osteoblast differentiation, and bone nodule formation. Glutamate was found to have no effect on the survival or activity of mature osteoclasts, although glutamate transporter inhibition and receptor blockade increased the number of bone resorption pits. Furthermore, transporter inhibition increased the area of resorbed bone while significantly decreasing the number of osteoclasts. Alkaline phosphatase activity and extracellular matrix mineralization were used as measurements of osteoblast differentiation. Glutamate significantly increased osteoblast differentiation and mineralization, but transport inhibitors had no effect. These studies support earlier findings suggesting that glutamate may be more important for osteoclastogenesis than for osteoclast proliferation or functions. Since glutamate is capable of changing the differentiation and activities of both osteoclast and osteoblast cell types in bone, it is reasonable to postulate that tumour-derived glutamate may impact bone homeostasis in bone metastasis.

Biochemical and Biophysical Research Communications, 2010

Although the amino acid glutamate is used as an intercellular signaling molecule for normal bone ... more Although the amino acid glutamate is used as an intercellular signaling molecule for normal bone homeostasis, little is known regarding its possible role in the metabolic disruption characteristic of bone metastasis. We have previously shown in vitro that cancer cell lines relevant to bone metastasis release glutamate into the extracellular environment. This study demonstrates the expression of multiple glutamate transporters in cancer cell lines of non-central nervous system origin. Furthermore, we identify the molecular mechanism responsible for glutamate export and show that this system can be inhibited pharmacologically. By highlighting that glutamate secretion is a common biological feature of cancer cells, this study suggests that tumor-derived glutamate could interfere with glutamate-dependent intercellular signaling in normal bone. Pharmacological interference with cancer cell glutamate release may be a viable option for limiting host bone response to invading tumor cells in bone metastasis.