basant kumar | Sanjay Gandhi Postgraduate Institute of Medician Sciences, Lucknow (original) (raw)

Papers by basant kumar

Journal of Pediatric Neurosciences, 2012

Silver-Russell syndrome (SRS) is a rare, heterogeneous, genetic disorder; characterize by intraut... more Silver-Russell syndrome (SRS) is a rare, heterogeneous, genetic disorder; characterize by intrauterine and postnatal growth retardation, normal occipital-frontal circumference, body asymmetry and distinctive facial features. 90% of parents of children with SRS complain feeding problems but specific gastro-intestinal diseases have not been recognized as major features. We report a 6 years male child with SRS having malrotation of gut; needs surgery.

Journal of Neonatal Surgery, 2020

Background: Bowel obstruction in early infancy may results from variety of congenital anomalies i... more Background: Bowel obstruction in early infancy may results from variety of congenital anomalies involving small and large bowel. Colonic stenosis (CS) congenital or acquired is among the rare causes of chronic bowel obstructions in early infancy. Methods: Medical record of 4 patients with colonic stenosis secondary to Hirschsprung’s disease was reviewed. Results: A total of 4 cases were included in the study. Age of presentation ranged from 25 days to 96 days. Most common presentation was gross abdominal distension with visible bowel loop, vomiting, difficulty in passing stool followed by history of passing recurrent loose stools and failure to thrive. In one case there was suspicion of bowel perforation and was operated in emergency. Initial operative findings and histopathology was not suggestive of Hirschsprung’s Disease, but a full thickness rectal biopsy confirmed HD in all 4 cases. Conclusion: Hirschsprung should be considered as underlying pathology in cases of colonic strict...

Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India

Intralesional bleomycin scelro-therapy has become a favored line of treatment for macrocystic lym... more Intralesional bleomycin scelro-therapy has become a favored line of treatment for macrocystic lymphatic malformations. However the need for multiple sessions is a drawback associated with this treatment modality. Our aim is to document whether multiple session of intra- lesional sclero-therapy is necessary for complete resolution of cystic lymphatic malformation. Intralesional bleomycin under Ultrasound guidance was used for macrocystic lymphangioma at concentration of 3mg/ml but not exceeding the total dose (1mg/kg) body weight for single session or cumulative dose of 5mg/kg. In all cases intralesional sclerosant (ILS) was installed under proper aseptic precaution in operation theatre in general anesthesia or sedation depending on the site or size of lesion and age of the patient. Age of patients at the time of enrolment in study ranged from 3 months to 18 years. Clinical examination was the main stay of diagnosis which was supplemented by USG and/or computed tomography. Compressio...

African journal of paediatric surgery : AJPS

To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for... more To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for early diagnosis and management. From December 2010 to April 2016, available electronic and operation theatre (OT) records of 17 patients with confirmed diagnosis of abdominal TB were analysed retrospectively. Parameters reviewed were age, sex, presentations, diagnostic investigations, surgery/intervention performed, final outcome and follow-up. Out of 17 patients, 6 (35.3%) were already operated elsewhere. The duration of symptoms ranged from 4 to 58 weeks. Abdominal pain was present in all cases whereas 11 (64.7%) had abdominal distension, 16 (94.1%) fever, 14 (82.3%) ascites, 9 (52.9%) vomiting, 14 (82.3%) weight loss, 6 (35.3%) anorexia and 4 (23.5%) night sweat. All patients needed surgical intervention for definitive diagnosis. Thirteen (76.5%) out of 17 patients managed by staged surgery and primary anastomosis/repair/adhesiolysis were done in 4 (23.5%) patients. The main post-ope...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017

IFCC differs from cyst in children (classical children) and adults in presentation, pathology, co... more IFCC differs from cyst in children (classical children) and adults in presentation, pathology, complication and outcome. Todani T et al., have characterized the IFCC as follows: cystic choledochal dilatation, abdominal mass with jaundice and acholic stools, no symptomatic association with acute pancreatitis and a low amylase level in bile [1]. We are presenting four cases of huge IFCC presented in newborns and infants of which three were managed with external biliary drainage before definitive treatment. CaSe 1 A seven-month-old female child presented with high grade fever, jaundice, passing pale stool, abdominal distension and vomiting since five days. Clinical examination revealed that she was malnourished, had abdominal distension with palpable liver and free fluid. History of jaundice and passing pale stool was noticed since age of one month. Haematological, biochemical and liver function tests were abnormal [Table/Fig-1]. Ultrasound and Magenetic Resonance Cholangiopancreatography (MRCP) showed Todani Type-I Choledochal Cyst (CC) [Table/Fig-2]. Patient was initially managed with intravenous fluid, antibiotics and blood products and considered for excision of the cyst and Rous-en-Y hepaticojejunostomy (RYHJ) after stabilization (after two weeks). On exploration, it was a large cyst with grossly distended gall bladder and cystic duct. Cyst was oedematous and inflamed with lot of free fluid. Dissection of the cyst was difficult because of inflammation and tissue oedema; hence surgery was prolonged (more than six hours). Liver was hard and dark, Histopathology Examination (HPE) of liver showed distorted hepatic architecture with bridging fibrosis, ductular proliferation, widening of portal tracts and formation of nodule. Postoperative course was complicated, needed ventilator support for more than 24 hours, developed wound infection and partial wound dehiscence, chest infection, fever, hypoalbunemia and electrolyte imbalance due to high drain output. Patient was allowed oral feed on eight Postoperative Day (POD) and was discharged on 20 th POD due to issue related to high drain output and sepsis. Liver function was on improving trend and almost normalized in follow up after one year [Table/Fig-3]. Patient developed incisional hernia but now thriving well and waiting for repair.

Journal of clinical and diagnostic research : JCDR, 2017

Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymp... more Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymptomatic abdominal lump to acute intestinal obstruction. We discuss two cases of lymphangioma of small bowel mesentery who presented to us as acute intestinal obstruction. In the first case exploratory laparotomy revealed a large multicystic lesion arising from small bowel mesentery just distal to the duodenojejunal junction having multiple small cysts filled with milky white fluid. The involved region of the bowel was excised. The second case had a large multicystic lesion involving the mesentery of proximal jejunum, dudenojejunal junction, encasing the entire superior mesenteric vessels. For this patient, debulking was done.

Journal of cutaneous and aesthetic surgery

transfer using a pocket dermatoscope which gives a ×10 magnification (DermLite DL3, 3Gen Inc., US... more transfer using a pocket dermatoscope which gives a ×10 magnification (DermLite DL3, 3Gen Inc., USA) at least 3 months after the surgical procedure. Images were taken with a Sony Cybershot DSC-W800 20.1 MP digital camera after attaching it to the dermatoscope with a universal adapter [Figures 1-5]. The best colour match was seen with non-cultured epidermal cell suspension followed by follicular unit extraction. We direct further studies in evaluating the colour match with the dermatoscope comparing it with objective tools such as colorimeter in future and prospective studies with standardised protocols taking sites, type of vitiligo and adjuvant therapy into consideration as well. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, Jan 27, 2017

Objective Surgery is still indicated as the treatment of choice in subset of patients with unilat... more Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature. Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure > 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy was performed in all children in variable time duration. Hypertension, urinary tract infection, and desire of parents were the main indication of surgery. Results All children showed decrease in the size of their dysplastic kidney with time, but hypertension was persistent...

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, Jan 27, 2017

Objective Surgery is still indicated as the treatment of choice in subset of patients with unilat... more Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature. Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure > 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy was performed in all children in variable time duration. Hypertension, urinary tract infection, and desire of parents were the main indication of surgery. Results All children showed decrease in the size of their dysplastic kidney with time, but hypertension was persistent...

West African Journal of Radiology, 2017

Objective: To analyze the technical and clinical outcomes of transarterial embolization in patien... more Objective: To analyze the technical and clinical outcomes of transarterial embolization in patients with nonvariceal gastrointestinal (GI) bleeding in our institute. Materials and Methods: From July 2009 to June 2013, retrospective data of all patients with nonvariceal GI bleeding who underwent catheter-directed angiography with or without Transarterial Embolization (TAE) were collected and included in the study. All were inpatients at the time of the procedures, and they were followed up till discharge or demise. Results: Out of 152 patients, 127 cases (age - 12-94 years; median age - 47 years) of GI bleeding were included in the study. Male to female ratio was ~4:1. Catheter-directed angiography was tried in all 127 patients. Out of 37 patients (29%) who had a normal angiogram, 26 (70%) improved spontaneously without embolization whereas in 11 (30%) the bleeding source could not be identified even with a repeat angiogram and clinical evidence of haemorrhage requiring surgery. Out of 90 patients (71%) with angiographically visible bleeding; 88 (69.3%) had successful, catheter directed trans-arterial embolization (TAE) whereas in 2 patients (2.2%), the bleeding vessel could not be cannulated (technical failure). Complications were encountered in 11 patients (8.7%) and rebleeding occurred in 3 patients (3.4%). Angiography related mortality was 4.7% (6/127). Conclusion: Endovascular treatment can be performed safely in sick patients. It is technically demanding, and it is not always possible for anatomic reasons or because of distorted anatomy due to previous surgeries.

Journal of Neonatal Surgery, 2016

Incomplete intestinal obstruction due to windsock web of the jejunum is uncommonly notice in neon... more Incomplete intestinal obstruction due to windsock web of the jejunum is uncommonly notice in neonates. We present a male neonate, prenatally suspected case of proximal bowel obstruction, who was found to have features of incomplete intestinal obstruction due to windsock deformity in jejunum. The difficulty in the diagnosis and management is discussed along with relevant literature review.

World Journal of Endocrine Surgery, 2015

Pathologically elevated vasoactive intestinal polypeptide (VIP) plasma levels cause secretory dia... more Pathologically elevated vasoactive intestinal polypeptide (VIP) plasma levels cause secretory diarrhea with excessive loss of water and electrolyte and is characterized by the typical symptoms of hypokalemia and metabolic acidosis. It rarely occurs in patients with non-pancreatic disease. Despite the clinical severity, diagnosis of a VIP-secreting tumor is often delayed. We herein present a 14-month-old boy having prolonged therapy-resistant secretory diarrhea, persistent hypokalemia with tissue diagnosis of ganglioneuroblastoma and raised plasma VIP-levels.

World Journal of Endocrine Surgery, 2012

The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected ... more The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected by a narrow median isthmus thus giving an ‘H’-shaped appearance to the gland. Congenital thyroid abnormalities mostly include unilateral lobar agenesis, with or without involving the isthmus. We are reporting a case rudimentary right lobe with absence of isthmus. The knowledge of various developmental anomalies of the gland and variations in neurovascular relations will help the surgeon in better planning of a safe and effective surgery. How to cite this article Sthapak E, Gajbe UL, Wanjari SP, Upadhyaya VD, Kumar B. Thyroid Agenesis: A Case Report with Review of Literature. World J Endoc Surg 2012;4(3): 99-101.

Open Journal of Pediatrics, 2012

Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A ca... more Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A case of one year old child who underwent gastric pull-up for complicated tracheo-esophageal fistula had jejunojejunal intussusception induced by Witzel's feeding jejunostomy tube; is discussed with review of literature.

Archives of International Surgery, 2014

Wandering spleen is a rare clinical entity that accounts for only 0.1-0.2% of all splenectomies. ... more Wandering spleen is a rare clinical entity that accounts for only 0.1-0.2% of all splenectomies. Early diagnosis and intervention is necessary for the preservation of the spleen, especially in children. However, most of the times in acute settings a precise clinical diagnosis is difficult because of its similarity of presentation with other causes of acute abdomen resulting in delayed diagnosis. We present a 12-year-old boy with left-sided abdominal pain following a fall from a bed. His abdominal examination revealed an enlarged tender spleen. Abdominal ultrasound and computed tomography showed enlarged spleen with multiple areas of infarction and thrombosis of the splenic vein. At laparotomy a diagnosis of torsion of a wandering spleen with infarction was confirmed and splenectomy done. We present the management of the patient with wandering spleen that presented as acute abdomen with lower abdominal mass and briefly review the literature.

Pediatric Radiology, 2009

Images of perforated choledochal cysts typically show an intraperitoneal fluid collection. We rep... more Images of perforated choledochal cysts typically show an intraperitoneal fluid collection. We report a case with, in addition to free intraperitoneal fluid, fluid collection in the right-side anterior pararenal and perirenal spaces. Surgery confirmed the presence of a perforation at the junction of the cystic duct and the common bile duct. This perforation may explain the biliary leakage extending into the free peritoneal space as well as into the anterior pararenal space and the hepatoduodenal ligament. Anterior pararenal and perirenal spaces communicate with the infrarenal space, and this may result in extension of the fluid into the perirenal space from the anterior pararenal space.

Cases Journal, 2008

Background Eventration of diaphragm associated with gastric volvulus is an uncommon condition. Ca... more Background Eventration of diaphragm associated with gastric volvulus is an uncommon condition. Case presentation We are reporting a case of a 60-year-old male having left sided total diaphragmatic eventration associated with chronic intermittent organo-axial gastric volvulus. The patient presented with progressive dyspnea and intermittent gastrointestinal symptoms. Plication of left hemidiaphragm with anterior gastropexy was performed through an abdominal approach. Postoperatively the patient's symptoms improved. Conclusion Symptomatic gastric volvulus associated with diaphragmatic eventration is a surgical emergency and always requires surgical repair.

Annals of Thoracic Medicine, 2008

A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left sid... more A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respiratory distress and electrolyte imbalance. Is congenital defect of chest wall associated with diaphragmatic hernia without ectopia cordis and omphalocele, an unusual variant of Cantrell's pentalogy?

African Journal of Paediatric Surgery, 2013

Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gas... more Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gastric tuberculosis found in only 1% of patients suffering from pulmonary tuberculosis with associated HIV infection in non-endemic areas. Duodenal obstruction due to tuberculosis is very rare and needs high index of suspicions for diagnosis. Mostly this entity is suspected on intraoperative findings. In this manuscript we emphasized on ways and means for establishing histopathological diagnosis before starting anti-tubercular treatment in such cases. Method and Material: All patients of suspected gastroduodenal tuberculosis presented with feature of gastric-outlet obstruction managed during Jan 2009 to June 2011 were included in the study. After proper evaluation (routine hematological and biochemical examination, microbiological examination, serological and endoscopic evaluation) exploratory laparotomy was done and if there is no mesenteric lymphadenopathy or it is not safe to take biopsy form the diseased duodenum, multiple FNAC were taken from the diseased portion for histopathological and microbiological diagnosis. Result: A total of fi ve patients were treated during this period. The most common presentation was vomiting followed by failure to thrive and weight loss; two patients had abdominal pain. Biopsy of mesenteric lymph node was possible in two cases. FNAC from diseases portion was taken in all cases. FNAC showed granulomas in four cases. Cases where even FNAC fi nding was non-conclusive on HPE/ Microbiology was not subjected to antitubercular drug. Conclusion: Multiple intra-operative FNAC may be taken from the diseased portion of the duodenum to establish the histopathological diagnosis if diagnosis is not established by any other mean.

Journal of Indian Association of Pediatric Surgeons

Despite the significant advancements in the management of anorectal malformations (ARMs), there a... more Despite the significant advancements in the management of anorectal malformations (ARMs), there are various surgical and functional complications reported. Complications are closely related with the surgical techniques adopted and the types of malformations. In this article, we present our experiences with ARM patients who required reoperation after unsuccessful previous surgeries or who had developed complications related to the previous surgical techniques. We retrospectively reviewed clinical and electronic records of all the patients with ARM who were operated for ARMs in our institute from June 2010 to May 2016. All ARM patients who needed reoperation were included in the study. These patients were previously operated outside our institute and referred to us with ongoing problems of constipation, stool impaction with overflow incontinence, perineal soiling, and difficult urination. There were 31 patients (M:F = 2.1:1) of ARM, reoperated for 38 indications during the above-menti...

Journal of Pediatric Neurosciences, 2012

Silver-Russell syndrome (SRS) is a rare, heterogeneous, genetic disorder; characterize by intraut... more Silver-Russell syndrome (SRS) is a rare, heterogeneous, genetic disorder; characterize by intrauterine and postnatal growth retardation, normal occipital-frontal circumference, body asymmetry and distinctive facial features. 90% of parents of children with SRS complain feeding problems but specific gastro-intestinal diseases have not been recognized as major features. We report a 6 years male child with SRS having malrotation of gut; needs surgery.

Journal of Neonatal Surgery, 2020

Background: Bowel obstruction in early infancy may results from variety of congenital anomalies i... more Background: Bowel obstruction in early infancy may results from variety of congenital anomalies involving small and large bowel. Colonic stenosis (CS) congenital or acquired is among the rare causes of chronic bowel obstructions in early infancy. Methods: Medical record of 4 patients with colonic stenosis secondary to Hirschsprung’s disease was reviewed. Results: A total of 4 cases were included in the study. Age of presentation ranged from 25 days to 96 days. Most common presentation was gross abdominal distension with visible bowel loop, vomiting, difficulty in passing stool followed by history of passing recurrent loose stools and failure to thrive. In one case there was suspicion of bowel perforation and was operated in emergency. Initial operative findings and histopathology was not suggestive of Hirschsprung’s Disease, but a full thickness rectal biopsy confirmed HD in all 4 cases. Conclusion: Hirschsprung should be considered as underlying pathology in cases of colonic strict...

Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India

Intralesional bleomycin scelro-therapy has become a favored line of treatment for macrocystic lym... more Intralesional bleomycin scelro-therapy has become a favored line of treatment for macrocystic lymphatic malformations. However the need for multiple sessions is a drawback associated with this treatment modality. Our aim is to document whether multiple session of intra- lesional sclero-therapy is necessary for complete resolution of cystic lymphatic malformation. Intralesional bleomycin under Ultrasound guidance was used for macrocystic lymphangioma at concentration of 3mg/ml but not exceeding the total dose (1mg/kg) body weight for single session or cumulative dose of 5mg/kg. In all cases intralesional sclerosant (ILS) was installed under proper aseptic precaution in operation theatre in general anesthesia or sedation depending on the site or size of lesion and age of the patient. Age of patients at the time of enrolment in study ranged from 3 months to 18 years. Clinical examination was the main stay of diagnosis which was supplemented by USG and/or computed tomography. Compressio...

African journal of paediatric surgery : AJPS

To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for... more To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for early diagnosis and management. From December 2010 to April 2016, available electronic and operation theatre (OT) records of 17 patients with confirmed diagnosis of abdominal TB were analysed retrospectively. Parameters reviewed were age, sex, presentations, diagnostic investigations, surgery/intervention performed, final outcome and follow-up. Out of 17 patients, 6 (35.3%) were already operated elsewhere. The duration of symptoms ranged from 4 to 58 weeks. Abdominal pain was present in all cases whereas 11 (64.7%) had abdominal distension, 16 (94.1%) fever, 14 (82.3%) ascites, 9 (52.9%) vomiting, 14 (82.3%) weight loss, 6 (35.3%) anorexia and 4 (23.5%) night sweat. All patients needed surgical intervention for definitive diagnosis. Thirteen (76.5%) out of 17 patients managed by staged surgery and primary anastomosis/repair/adhesiolysis were done in 4 (23.5%) patients. The main post-ope...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017

IFCC differs from cyst in children (classical children) and adults in presentation, pathology, co... more IFCC differs from cyst in children (classical children) and adults in presentation, pathology, complication and outcome. Todani T et al., have characterized the IFCC as follows: cystic choledochal dilatation, abdominal mass with jaundice and acholic stools, no symptomatic association with acute pancreatitis and a low amylase level in bile [1]. We are presenting four cases of huge IFCC presented in newborns and infants of which three were managed with external biliary drainage before definitive treatment. CaSe 1 A seven-month-old female child presented with high grade fever, jaundice, passing pale stool, abdominal distension and vomiting since five days. Clinical examination revealed that she was malnourished, had abdominal distension with palpable liver and free fluid. History of jaundice and passing pale stool was noticed since age of one month. Haematological, biochemical and liver function tests were abnormal [Table/Fig-1]. Ultrasound and Magenetic Resonance Cholangiopancreatography (MRCP) showed Todani Type-I Choledochal Cyst (CC) [Table/Fig-2]. Patient was initially managed with intravenous fluid, antibiotics and blood products and considered for excision of the cyst and Rous-en-Y hepaticojejunostomy (RYHJ) after stabilization (after two weeks). On exploration, it was a large cyst with grossly distended gall bladder and cystic duct. Cyst was oedematous and inflamed with lot of free fluid. Dissection of the cyst was difficult because of inflammation and tissue oedema; hence surgery was prolonged (more than six hours). Liver was hard and dark, Histopathology Examination (HPE) of liver showed distorted hepatic architecture with bridging fibrosis, ductular proliferation, widening of portal tracts and formation of nodule. Postoperative course was complicated, needed ventilator support for more than 24 hours, developed wound infection and partial wound dehiscence, chest infection, fever, hypoalbunemia and electrolyte imbalance due to high drain output. Patient was allowed oral feed on eight Postoperative Day (POD) and was discharged on 20 th POD due to issue related to high drain output and sepsis. Liver function was on improving trend and almost normalized in follow up after one year [Table/Fig-3]. Patient developed incisional hernia but now thriving well and waiting for repair.

Journal of clinical and diagnostic research : JCDR, 2017

Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymp... more Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymptomatic abdominal lump to acute intestinal obstruction. We discuss two cases of lymphangioma of small bowel mesentery who presented to us as acute intestinal obstruction. In the first case exploratory laparotomy revealed a large multicystic lesion arising from small bowel mesentery just distal to the duodenojejunal junction having multiple small cysts filled with milky white fluid. The involved region of the bowel was excised. The second case had a large multicystic lesion involving the mesentery of proximal jejunum, dudenojejunal junction, encasing the entire superior mesenteric vessels. For this patient, debulking was done.

Journal of cutaneous and aesthetic surgery

transfer using a pocket dermatoscope which gives a ×10 magnification (DermLite DL3, 3Gen Inc., US... more transfer using a pocket dermatoscope which gives a ×10 magnification (DermLite DL3, 3Gen Inc., USA) at least 3 months after the surgical procedure. Images were taken with a Sony Cybershot DSC-W800 20.1 MP digital camera after attaching it to the dermatoscope with a universal adapter [Figures 1-5]. The best colour match was seen with non-cultured epidermal cell suspension followed by follicular unit extraction. We direct further studies in evaluating the colour match with the dermatoscope comparing it with objective tools such as colorimeter in future and prospective studies with standardised protocols taking sites, type of vitiligo and adjuvant therapy into consideration as well. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, Jan 27, 2017

Objective Surgery is still indicated as the treatment of choice in subset of patients with unilat... more Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature. Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure > 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy was performed in all children in variable time duration. Hypertension, urinary tract infection, and desire of parents were the main indication of surgery. Results All children showed decrease in the size of their dysplastic kidney with time, but hypertension was persistent...

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, Jan 27, 2017

Objective Surgery is still indicated as the treatment of choice in subset of patients with unilat... more Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature. Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure > 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy was performed in all children in variable time duration. Hypertension, urinary tract infection, and desire of parents were the main indication of surgery. Results All children showed decrease in the size of their dysplastic kidney with time, but hypertension was persistent...

West African Journal of Radiology, 2017

Objective: To analyze the technical and clinical outcomes of transarterial embolization in patien... more Objective: To analyze the technical and clinical outcomes of transarterial embolization in patients with nonvariceal gastrointestinal (GI) bleeding in our institute. Materials and Methods: From July 2009 to June 2013, retrospective data of all patients with nonvariceal GI bleeding who underwent catheter-directed angiography with or without Transarterial Embolization (TAE) were collected and included in the study. All were inpatients at the time of the procedures, and they were followed up till discharge or demise. Results: Out of 152 patients, 127 cases (age - 12-94 years; median age - 47 years) of GI bleeding were included in the study. Male to female ratio was ~4:1. Catheter-directed angiography was tried in all 127 patients. Out of 37 patients (29%) who had a normal angiogram, 26 (70%) improved spontaneously without embolization whereas in 11 (30%) the bleeding source could not be identified even with a repeat angiogram and clinical evidence of haemorrhage requiring surgery. Out of 90 patients (71%) with angiographically visible bleeding; 88 (69.3%) had successful, catheter directed trans-arterial embolization (TAE) whereas in 2 patients (2.2%), the bleeding vessel could not be cannulated (technical failure). Complications were encountered in 11 patients (8.7%) and rebleeding occurred in 3 patients (3.4%). Angiography related mortality was 4.7% (6/127). Conclusion: Endovascular treatment can be performed safely in sick patients. It is technically demanding, and it is not always possible for anatomic reasons or because of distorted anatomy due to previous surgeries.

Journal of Neonatal Surgery, 2016

Incomplete intestinal obstruction due to windsock web of the jejunum is uncommonly notice in neon... more Incomplete intestinal obstruction due to windsock web of the jejunum is uncommonly notice in neonates. We present a male neonate, prenatally suspected case of proximal bowel obstruction, who was found to have features of incomplete intestinal obstruction due to windsock deformity in jejunum. The difficulty in the diagnosis and management is discussed along with relevant literature review.

World Journal of Endocrine Surgery, 2015

Pathologically elevated vasoactive intestinal polypeptide (VIP) plasma levels cause secretory dia... more Pathologically elevated vasoactive intestinal polypeptide (VIP) plasma levels cause secretory diarrhea with excessive loss of water and electrolyte and is characterized by the typical symptoms of hypokalemia and metabolic acidosis. It rarely occurs in patients with non-pancreatic disease. Despite the clinical severity, diagnosis of a VIP-secreting tumor is often delayed. We herein present a 14-month-old boy having prolonged therapy-resistant secretory diarrhea, persistent hypokalemia with tissue diagnosis of ganglioneuroblastoma and raised plasma VIP-levels.

World Journal of Endocrine Surgery, 2012

The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected ... more The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected by a narrow median isthmus thus giving an ‘H’-shaped appearance to the gland. Congenital thyroid abnormalities mostly include unilateral lobar agenesis, with or without involving the isthmus. We are reporting a case rudimentary right lobe with absence of isthmus. The knowledge of various developmental anomalies of the gland and variations in neurovascular relations will help the surgeon in better planning of a safe and effective surgery. How to cite this article Sthapak E, Gajbe UL, Wanjari SP, Upadhyaya VD, Kumar B. Thyroid Agenesis: A Case Report with Review of Literature. World J Endoc Surg 2012;4(3): 99-101.

Open Journal of Pediatrics, 2012

Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A ca... more Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A case of one year old child who underwent gastric pull-up for complicated tracheo-esophageal fistula had jejunojejunal intussusception induced by Witzel's feeding jejunostomy tube; is discussed with review of literature.

Archives of International Surgery, 2014

Wandering spleen is a rare clinical entity that accounts for only 0.1-0.2% of all splenectomies. ... more Wandering spleen is a rare clinical entity that accounts for only 0.1-0.2% of all splenectomies. Early diagnosis and intervention is necessary for the preservation of the spleen, especially in children. However, most of the times in acute settings a precise clinical diagnosis is difficult because of its similarity of presentation with other causes of acute abdomen resulting in delayed diagnosis. We present a 12-year-old boy with left-sided abdominal pain following a fall from a bed. His abdominal examination revealed an enlarged tender spleen. Abdominal ultrasound and computed tomography showed enlarged spleen with multiple areas of infarction and thrombosis of the splenic vein. At laparotomy a diagnosis of torsion of a wandering spleen with infarction was confirmed and splenectomy done. We present the management of the patient with wandering spleen that presented as acute abdomen with lower abdominal mass and briefly review the literature.

Pediatric Radiology, 2009

Images of perforated choledochal cysts typically show an intraperitoneal fluid collection. We rep... more Images of perforated choledochal cysts typically show an intraperitoneal fluid collection. We report a case with, in addition to free intraperitoneal fluid, fluid collection in the right-side anterior pararenal and perirenal spaces. Surgery confirmed the presence of a perforation at the junction of the cystic duct and the common bile duct. This perforation may explain the biliary leakage extending into the free peritoneal space as well as into the anterior pararenal space and the hepatoduodenal ligament. Anterior pararenal and perirenal spaces communicate with the infrarenal space, and this may result in extension of the fluid into the perirenal space from the anterior pararenal space.

Cases Journal, 2008

Background Eventration of diaphragm associated with gastric volvulus is an uncommon condition. Ca... more Background Eventration of diaphragm associated with gastric volvulus is an uncommon condition. Case presentation We are reporting a case of a 60-year-old male having left sided total diaphragmatic eventration associated with chronic intermittent organo-axial gastric volvulus. The patient presented with progressive dyspnea and intermittent gastrointestinal symptoms. Plication of left hemidiaphragm with anterior gastropexy was performed through an abdominal approach. Postoperatively the patient's symptoms improved. Conclusion Symptomatic gastric volvulus associated with diaphragmatic eventration is a surgical emergency and always requires surgical repair.

Annals of Thoracic Medicine, 2008

A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left sid... more A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respiratory distress and electrolyte imbalance. Is congenital defect of chest wall associated with diaphragmatic hernia without ectopia cordis and omphalocele, an unusual variant of Cantrell's pentalogy?

African Journal of Paediatric Surgery, 2013

Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gas... more Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gastric tuberculosis found in only 1% of patients suffering from pulmonary tuberculosis with associated HIV infection in non-endemic areas. Duodenal obstruction due to tuberculosis is very rare and needs high index of suspicions for diagnosis. Mostly this entity is suspected on intraoperative findings. In this manuscript we emphasized on ways and means for establishing histopathological diagnosis before starting anti-tubercular treatment in such cases. Method and Material: All patients of suspected gastroduodenal tuberculosis presented with feature of gastric-outlet obstruction managed during Jan 2009 to June 2011 were included in the study. After proper evaluation (routine hematological and biochemical examination, microbiological examination, serological and endoscopic evaluation) exploratory laparotomy was done and if there is no mesenteric lymphadenopathy or it is not safe to take biopsy form the diseased duodenum, multiple FNAC were taken from the diseased portion for histopathological and microbiological diagnosis. Result: A total of fi ve patients were treated during this period. The most common presentation was vomiting followed by failure to thrive and weight loss; two patients had abdominal pain. Biopsy of mesenteric lymph node was possible in two cases. FNAC from diseases portion was taken in all cases. FNAC showed granulomas in four cases. Cases where even FNAC fi nding was non-conclusive on HPE/ Microbiology was not subjected to antitubercular drug. Conclusion: Multiple intra-operative FNAC may be taken from the diseased portion of the duodenum to establish the histopathological diagnosis if diagnosis is not established by any other mean.

Journal of Indian Association of Pediatric Surgeons

Despite the significant advancements in the management of anorectal malformations (ARMs), there a... more Despite the significant advancements in the management of anorectal malformations (ARMs), there are various surgical and functional complications reported. Complications are closely related with the surgical techniques adopted and the types of malformations. In this article, we present our experiences with ARM patients who required reoperation after unsuccessful previous surgeries or who had developed complications related to the previous surgical techniques. We retrospectively reviewed clinical and electronic records of all the patients with ARM who were operated for ARMs in our institute from June 2010 to May 2016. All ARM patients who needed reoperation were included in the study. These patients were previously operated outside our institute and referred to us with ongoing problems of constipation, stool impaction with overflow incontinence, perineal soiling, and difficult urination. There were 31 patients (M:F = 2.1:1) of ARM, reoperated for 38 indications during the above-menti...