Browsing by Author "Indra Singh Choudhary"

Now showing 1 - 2 of 2

Evaluating Trainee Performance and Surgical Safety: A Comparison of Supine and Left Lateral Positioning in Pediatric Laparoscopic Appendectomy
(Mary Ann Liebert Inc., 2025) Vaibhav Pandey; Shashi Prakash Mishra; Indra Singh Choudhary; Bhanumurthy Marripati Kaushik; Amit Gupta; Ruchira Nandan
Background: Laparoscopic appendectomy is the preferred treatment for acute appendicitis, offering reduced morbidity and quicker recovery compared with open surgery. The positioning of the patient during surgery can significantly impact both the ergonomics for the surgeon and the operational outcomes. This study compares the conventional supine positioning with an innovative left lateral decubitus approach for surgical efficiency and recovery outcomes. Methods: This prospective, comparative study included 30 pediatric patients undergoing interval appendectomy at the Department of Pediatric Surgery, from October 2023 to March 2024. Patients were randomly assigned to undergo appendectomy either in the traditional supine position (Group A) or a modified left lateral position (Group B). The study measured operative times, complication rates, and surgical outcomes using the modified Objective Structured Assessment of Technical Skills (OSATS). Results: The study consisted of 15 patients in each group, with comparable demographics and baseline characteristics. Group B showed a significant reduction in mean operating time (55.25 ± 3.62 minutes) compared with Group A (62.45 ± 4.15 minutes) (P < .001). There were fewer complications in Group B, with no serosal tears reported compared with a 15.3% incidence in Group A. The modified OSATS scores were higher in Group B, indicating better flow of operation and overall performance. Conclusion: The left lateral positioning in pediatric laparoscopic appendectomy demonstrated a potential to enhance surgical efficiency, reduce operative time, and minimize complications compared with the traditional supine approach. These findings suggest that the left lateral position could be considered a preferable alternative in pediatric appendectomy, particularly beneficial for surgical trainees due to improved ergonomics. © 2025 Mary Ann Liebert, Inc., publishers
Impact of Dual‑coated Silver Nanoparticle and Antibiotic Sutures on Wound Healing in Inflammatory Mouse Models
(Wolters Kluwer Medknow Publications, 2024) Vaibhav Pandey; Amit Gupta; Indra Singh Choudhary; Mohammad Imran; Shyam Lal Mudavath; Amrita Ghosh Kar; Ruchira Nandan
Background: The use of silver nanoparticles (AgNPs) in biomedicine has emerged in a big way owing to its antibacterial and anti‑inflammatory properties. We hypothesize that combining the AgNPs with antibiotics for coating sutures will enhance the antibacterial property of sutures with the added advantage of the immunomodulatory effect of AgNPs on tissue healing. Materials and Methods: Polyglactin sutures were coated with AgNPs using the dip‑coating method. The uniform coating and morphology of AgNPs on the suture surface were confirmed using scanning electron microscopy (SEM). Each type of suture – polyglactin plain, antibiotic coated (Triclosan), AgNP coated, and dually coated (antibiotic and AgNP) – was assessed for their antibacterial properties against Gram‑positive bacteria, Gram‑negative bacteria, and anaerobes. These sutures were utilized in an abdominal and systemic inflammatory mice model for ileal anastomosis. The intestinal tissue was evaluated for acute and chronic inflammation and collagen deposition to assess the healing and inflammatory response. Results: The SEM and energy dispersive X‑ray analysis showed successful coating of AgNPs on plain and antibiotic‑coated sutures. In comparison with the other groups, the dually coated suture had the best in vitro antibacterial efficacy. The AgNP‑coated sutures were able to decrease both acute and chronic inflammatory cell infiltration, but the collagen synthesis and deposition were enhanced. Conclusion: AgNPs can be coated on Polyglactin suture either alone or in combination with antibiotics with preserved antibacterial effects. The dual coating of sutures gives a synergistic antibacterial effect. The AgNP diminishes immune response in the presence of preserved extracellular matrix generation. © 2024 Journal of Indian Association of Pediatric Surgeons.