Browsing by Author "Rahul Khanna"

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A case series describing 118 patients with lower limb necrotizing fasciitis
(2009) A.K. Khanna; Satyendra K. Tiwary; Puneet Kumar; Rahul Khanna; Anuradha Khanna
Necrotizing fasciitis of the lower limb is not uncommon, with poor outcome. This study reviewed 118 cases (78 males and 40 females) with mean age of 45 + 16.5 years (range 12-95 years) of lower limb necrotizing fasciitis admitted to the Department of Surgery, BHU in India between 1995 and 2007. Most patients (n = 97) presented with fever. Other presenting symptoms included painful swelling, bullae, erythema, ulcer, and necrosis. Comorbid conditions such as diabetes, tuberculosis, malignancy, and immunosuppressive therapy were associated in 72 (61%) cases. Amputations were done in 24 patients. Thirty one patients developed septic shock. Renal dialysis was done in 16 patients and ventilatory support was needed in 12 patients. The most common organism identified was 2-hemolytic streptococci (n = 42). Eighteen patients died, a mortality of 15%. The authors consider early diagnosis and aggressive surgical intervention to be crucial for the successful treatment of disease. © 2009 Sage Publications.
Aggressive angiomyxoma presenting with huge abdominal lump: A case report
(BioMed Central Ltd., 2008) Sanjeev Kumar; Nikhil Agrawal; Rahul Khanna; A.K. Khanna
Agressive angiomyxoma is a rare mesenchymal neoplasm. It mainly presents in females. We here present a case of angiomyxoma presenting as huge abdominal lump along with gluteal swelling. Case note is described along with brief review of literature. © 2008 Al Kaissi et al; licensee BioMed Central Ltd.
Analysis of isocitrate dehydrogenase -2 (IDH2) activity in human serum as a biomarker in chemotherapy patients of breast carcinoma: A case-control study
(Journal of Clinical and Diagnostic Research, 2017) Roshni Gavel; S.P. Mishra; Seema Khanna; Rahul Khanna; Agni Gautam Shah
Introduction: Breast cancer represents a major public health problem in women worldwide. For many cancers, serum tumour markers play an important role in patient treatment and monitoring. Isocitrate dehydrogenase enzyme is also used as a biomarker for various types of cancer. The purpose of this study was to determine serum Isocitrate dehydrogenase-2 (IDH-2) enzyme activity in breast cancer patients (pre and post chemotherapy) and also correlate the changes in enzyme activity with stages of cancer and control groups. Materials and Methods: In this case-control study, histologically confirmed 40 female patients aged 28-80 years who fulfilled the criteria for diagnosis of invasive breast cancer were selected in our study groups from surgery outpatient department of SS Hospital, BHU, Varanasi, India, and 40 healthy age matched females were selected between March 2014 to July 2015. The estimation of serum IDH-2 enzyme activity in before and after two cycles of neoadjuvant chemotherapy patients was performed by spectrophotometry assay. Results: The mean serum IDH-2 activity in cases (Mean±SD) was significantly more than control group (p<0.001). The mean serum IDH-2 activity in cases was significantly decrease after neo-adjuvant chemotherapy (p=0.019). In stage II pre chemotherapy patients serum IDH-2 activity was higher than post chemotherapy (p<0.05), but in stage III the correlation between pre and post chemotherapy patients serum IDH-2 activity was not significant (p-value>0.05). Conclusion: The serum IDH-2 can be a potential biomarker in breast carcinoma and can be used for prognosis and monitoring the chemotherapy response of the patients. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.
Audit of Neurological Complications After Thyroid Surgery
(Springer, 2021) Rahul Khanna; Ram Niwas Meena; Rajesh Kumar; Siddharth Khanna
The incidence of permanent neurological complications after thyroid surgery is less than 2% and rarely life threatening. Most of the reported neurological complications are related to changes in voice or breathing difficulty. Symptoms of a foreign body sensation in the throat are an unpleasant and persistent complication, which has rarely been reported after thyroid surgery. Analysis of records of 170 patients undergoing various types of thyroid operations over a 6-year period was done. Postoperative complications with emphasis on the neurological complications were documented. The common post-thyroidectomy neurological complications noted were hoarseness of voice (6 patients), loss of voice pitch (7), breathy voice (8), respiratory stridor (2), and dysphagia to liquids (8). Most of these were transient and recovered spontaneously within weeks. Furthermore, we report a foreign body/sticky sensation in the throat as an atypical neurological complication. It was found to occur in 5 patients and significantly persisted in 3 patients at a 6-month follow-up after surgery. The postoperative symptoms commonly noticed after thyroid surgery were related to the motor innervation component of the external branch of the superior laryngeal or the recurrent laryngeal nerve. These symptoms underwent spontaneous resolution over a few weeks period after surgery in most of the patients. Additionally, we documented a foreign body sensation in the throat in 5 patients which is possibly a sequela of sensory denervation of the supra-glottic mucosa in the region supplied by the internal branch of the superior laryngeal nerve. Unlike motor symptoms, this foreign body sensation persisted in 3 out of 5 patients (60%) at 6 months of follow-up. © 2021, Association of Surgeons of India.
Basal cell nevus syndrome: A rare entity
(2012) Manish Bansal; Shri Nivash; Kajal Manchanda; Rahul Khanna
[No abstract available]
Case Report of a Pleomorphic Adenoma of Ear Lobule
(Wolters Kluwer Medknow Publications, 2024) Ram Niwas Meena; Roshit Jain; Rahul Khanna; Vipul Kumar Srivastava
Pleomorphic adenoma (PA) is the most common benign tumor which affects both major and minor salivary glands. The parotid gland is affected most of the time. Among the minor salivary glands, the palate is the most affected site, followed by lips, cheeks, gingiva, floor of the mouth, and tongue. PA of the auricle is very rare and even if they do so, they mostly arise from the external auditory canal. In this report, we present a case of PA of the ear lobule. © 2024 Indian Journal of Otology.
Cervical epidural anaesthesia for thyroid surgery
(Kathmandu University, 2009) Rahul Khanna; D.K. Singh
Background: Cervical epidural anaesthesia is a regional anaesthesia technique which has been used for upper limb surgery, upper thoracic wall surgery, carotid artery surgery and neck dissections. Anaesthesia for thyroid surgery can be complicated due to the altered functional status of the thyroid or its large size. Objective: This prospective study was designed to assess the effectiveness and safety of cervical epidural anaesthesia for thyroid surgery. Materials and methods: Cervical epidural anaesthesia was attempted in 9 patients and the results compared with 44 patients who underwent thyroid surgery under conventional general anaesthesia with endotracheal intubation. The epidural catheter was placed in the C7-T1 vertebral interspace and 10-15 ml of 1% Lignocaine with adrenaline was injected. Results: The technique of cervical epidural anaesthesia was successfully used in 8 out of 9 patients in whom it was attempted All patients were maintained in a state of conscious-sedation and effective analgesia was obtained in all 8 patients. There were no significant complications especially those related to diaphragmatic function and cardiovascular stability. In contrast patients undergoing surgery under conventional general anaesthesia had complications related to endotracheal intubation, cardiac arrhythmias and hypotension Conclusion: The technique of cervical epidural anaesthesia should be considered in thyroid patients where difficult endotracheal intubation is anticipated and in those in whom alterations in thyroid functional state make them vulnerable to cardiovascular complications under conventional general anaesthesia.
Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction
(2006) Satyendra K. Tiwary; Manish K. Singh; Rahul Khanna; Ajay K. Khanna
Background: Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation: A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion: Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel. © 2006 Tiwary et al; licensee BioMed Central Ltd.
Comparison of immunohistochemistry with conventional histopathology for evaluation of sentinel lymph node in breast cancer
(2011) Rahul Khanna; Shilpi Bhadani; Seema Khanna; Manoj Pandey; Mohan Kumar
The best method of pathological evaluation of sentinel lymph node in breast cancer has not been agreed upon. Immunohistochemical (IHC) techniques have shown a greater sensitivity over conventional histology for the detection of micrometastais. The aim of the study was to determine whether IHC for Epithelial Membrane Antigen (EMA) on the sentinel node could be more sensitive than conventional histology for diagnosing micrometastasis in sentinel lymph nodes. Eighty-four clinically node negative breast cancer patients underwent sentinel node biopsy at time of surgery for breast cancer. The node was subjected to conventional histopathology as well as IHC for EMA. The sensitivity of histology viz a viz IHC for EMA for detection of sentinel node metastasis was 88% and the specitficity was 96%. The overall diagnostic accuray of histology viz a viz IHC was 93%. There were 4 patients with micrometastasis (<2.0 mm), which were positive on IHC but negative on histology. Two patients with poorly differentiated breast cancer had a false negative IHC for EMA result as compared to histology. Immunohistochemistry for Epithelial Membrane Antigen can increase the detection rate of micrometastasis in sentinel lymph node. This can have important bearing on deciding the need of adjuvant systemic therapy. A false negative result for EMA may be seen in patients with poorly differential cancer. Therefore the best policy seems to employ both histopathology and IHC for EMA for the comprehensive evaluation of sentinel lymph node in breast cancer. © 2010 Association of Surgeons of India.
Comparison of Ligasure Hemorrhoidectomy with Conventional Ferguson's Hemorrhoidectomy
(2010) Rahul Khanna; Seema Khanna; Shilpi Bhadani; Sanjay Singh; Ajay K. Khanna
Conventional hemorrhoidectomy for grade III and IV hemorrhoids is a tedious procedure associated with significant morbidity and a prolonged convalescence. We compared Ligasure™ hemorrhoidectomy with conventional 'closed' Ferguson's hemorrhoidectomy for the treatment of grade III and IV hemorrhoids. Forty-eight consecutive patients of grade III and IV hemorrhoids were randomized to either the Ligasure™ hemorrhoidectomy (28 patients) or Ferguson's hemorrhoidectomy (20 patients). The hemorrhoidal predicle was coagulated with Ligasure™ in the Ligasure™ group and transfied with 2/0 chromic catgut in Ferguson's method. In comparison with Ferguson's method, Ligasure™ hemorrhoidectomy had a shorter operating time (29 vs 12.5 min), less blood loss (22 vs 11.5 ml), less post operative pain as measured on VAS scale and less postoperative complications including hemorrhage (10% vs 3.5%), urinary retention (10% vs 3.5%) and wound breakdown (20% vs 14%). The submucosal dissection technique with Ligasure™ coagulation of the hemorrhoidal pedicle is safe and effective. The blood vessels and tissue are reduced to a wafer thin seal with good hemostasis. Suturing is not required as the mucosal tissue over the pedicle is sealed off with the current. There is minimal lateral spread of either thermal or electrical energy. The external components of the hemorrhoids can also be treated at the same time. Because of its ease of use and less postoperative pain and complication Ligasure™ hemorrhoidectomy can be preformed as a day-care procedure. © Association of Surgeons of India 2010.
Correlating Receptor Status with Nottingham Prognostic Index in Breast Cancer
(Springer, 2024) Rohan Gupta; Rahul Khanna; Amrita G. Kar; Seema Khanna; Siddharth Khanna; Ram Niwas Meena
The biological behavior and prognosis of breast cancer is often unpredictable with a number of factors contributing to the outcome. Nottingham’s Prognostic Factor (NPI) takes into account the tumor size, nodal status, and histological grade of tumor. The receptor status considers the hormone receptor and HER2 status. The aim of the study was to correlate the NPI score with the receptor status expression in Indian women with breast cancer. A total of 78 breast cancer patients who underwent upfront modified radical mastectomy were recruited. NPI score and receptor status assessment was done at histopathological examination of the specimen. Hormone receptor negative breast cancer tended to have a higher NPI score compared to hormone receptor positive patients. However, this difference did not achieve statistical significance. NPI score parameters except for the histological grade are a reflection of the duration or time span of the tumor. On the contrary, the receptor status is indicative of the tumor biology and not of its time duration. A scoring system which incorporates the three parameters of the NPI as well as the receptor status would be the best prognostic index as well as predictive regarding the choice of adjuvant therapy. © Association of Surgeons of India 2023.
COVID-19 in India: Are biological and environmental factors helping to stem the incidence and severity?
(International Society on Aging and Disease, 2020) Sankha Shubhra Chakrabarti; Upinder Kaur; Anindita Banerjee; Upasana Ganguly; Tuhina Banerjee; Sarama Saha; Gaurav Parashar; Suvarna Prasad; Suddhachitta Chakrabarti; Amit Mittal; Bimal Kumar Agrawal; Ravindra Kumar Rawal; Robert Chunhua Zhao; Indrajeet Singh Gambhir; Rahul Khanna; Ashok K. Shetty; Kunlin Jin; Sasanka Chakrabarti
The ongoing Corona virus (COVID-19) pandemic has witnessed global political responses of unimaginable proportions. Many nations have implemented lockdowns that involve mandating citizens not to leave their residences for non-essential work. The Indian government has taken appropriate and commendable steps to curtail the community spread of COVID-19. While this may be extremely beneficial, this perspective discusses the other reasons why COVID-19 may have a lesser impact on India. We analyze the current pattern of SARS-CoV-2 transmission, testing, and mortality in India with an emphasis on the importance of mortality as a marker of the clinical relevance of COVID-19 disease. We also analyze the environmental and biological factors which may lessen the impact of COVID-19 in India. The importance of cross-immunity, innate immune responses, ACE polymorphism, and viral genetic mutations are discussed. © 2020 Chakrabarti S et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Craniofacial Cirsoid Aneurysm: 2-Stage Treatment
(2007) Satyendra K. Tiwary; Rahul Khanna; A.K. Khanna
[No abstract available]
Cytodiagnosis of the primary breast lymphoma in a young woman
(2013) Shashikant C.U. Patne; Mohan Kumar; Rahul Khanna
Primary breast lymphoma (PBL) is a rare entity. It represents 0.4% of malignant breast lesions and 2% of extranodal lymphomas. A 23-year-old woman presented with a left breast lump followed by palpable left axillary lymphadenopathy. Fine-needle aspiration cytology (FNAC) and histopathology were diagnostic of non-Hodgkin lymphoma-large cell type. Immunohistochemistry was positive against leukocyte common antigen and CD20. Because PBLs are uncommon malignant lesions and they usually do not have characteristic clinical and imaging findings, FNAC may prove to be a simple, rapid, reliable, and cost-effective procedure for successful diagnosis of the PBL.
Deliberate ingestion of sharp and long foreign bodies [3]
(2003) Rahul Khanna; Mumtaz Ansari; Nitin; Seema Singh; Anand Kumar
[No abstract available]
Detection of human papilloma virus 16 and 18 DNA sequences by southern blot hybridization in oral leukoplakia and squamous cell carcinoma
(2009) Rahul Khanna; G.R.K. Rao; S.K. Tiwary; Ashish Rai; Seema Khanna; A.K. Khanna
Background: The etiopathological role of human papilloma virus (HPV) in the causation of oral cancer is till a subject of speculation. Methods: We used the technique of Southern blot hybridization to detect the presence of HPV types 16 & 18 in biopsy specimens from oral cancer and leukoplakia patients as well as normal oral mucosal biopsies. Results: The prevalence of either HPV type 16 or 18 was found in 64.5% (29/45) of oral cancer, 40%(12/30) of leukoplakia and 20%(9/45) of normal oral mucosal biopsies. No association could be demonstrated between tobacco usage habits or a history of genital warts with HPV prevalence. Conclusion: A significant finding was that none of the oral cancer patients were negative for both: a history of tobacco usage as well as presence of HPV infection, on Southern blot hybridization. © 2009 Association of Surgeons of India.
Detection of human papilloma viruses 16 and 18 DNA sequences in oral squamous cell carcinoma [4]
(2007) Rahul Khanna; G.R.K. Rao; Satyendra K. Tiwary; Ashish Rai; Seema Khanna; Ajay K. Khanna
[No abstract available]
Distal Duodenal Obstruction: a Surgical Enigma
(Springer India, 2017) Seema Khanna; Piyush Gupta; Rahul Khanna; Disha Dalela
The postbulbar segment also known as the distal duodenum is a separate clinical entity in terms of the intrinsic pathologies of this region and its varied anatomical relations. The common bile duct and the pancreatic duct open through the major papilla, which marks the beginning of this segment. Distal duodenal obstruction can be defined as a clinicoradiological entity that is characterized by features of gastric outlet obstruction with recurrent bilious vomiting and a radiological evidence of postbulbar obstruction. A Medline search for distal duodenal obstruction revealed 1409 entries, mostly in the form of case reports. In the last 10 years, 310 cases are reported. Clinical features like abdominal pain, nausea, and vomiting are non-specific and quite similar to gastric outlet obstruction. Clinical findings are also non-specific and do not aid in diagnosis. Laboratory findings also do not add much. Contrast-enhanced CT scan and MR enterography are diagnostic modalities of choice. Distal duodenal obstruction is a clinical entity that has a wide list of differential diagnosis which requires due consideration in terms of its management and follow-up. Most of these lesions require adequate workup with the help of a multidisciplinary team consisting of radiologists, gastroenterologists, and pathologists to adequately diagnose and stage the disease before a treatment plan is formulated. A thorough knowledge is a must regarding the treatment options available for each of the conditions so that the management can be personalized leading to better results. © 2017, Association of Surgeons of India.
Efficacy of Platelet-Rich Plasma in Alleviating Split Skin Graft Morbidities
(Wolters Kluwer Medknow Publications, 2024) Veda Samhitha Chigurupati; Seema Khanna; Sandip Kumar; Rahul Khanna
Introduction: Skin grafting is a routinely employed technique to cover the skin defect. Though the skin grafts are technically effortless, they are tiresome because of the prolonged duration of hospital stay, labor–intensive, demanding repeated dressings, and also create a second wound. Platelet-rich plasma (PRP) is one that has a higher concentration of platelets than the blood. Alpha granules of the platelets are rich in growth factors. Aims and Objectives: To assess the effect of PRP on split-thickness skin graft uptake and donor site healing. Materials and Methods: In a single-center-based prospective study done from August 2018 to June 2020, 60 patients with acute and chronic wounds were divided into two equal groups. Autologous PRP was applied on the recipient wound bed and donor site in PRP group, and conventional methods like staples/sutures were used to anchor the skin grafts and standard of care of the donor site in a control group. Results: Instantaneous graft adhesion was observed in all patients of PRP group. The first graft inspection was delayed. Seroma, hematoma, total number of dressings, and duration of stay in hospital were significantly reduced in the PRP group. Donor site pain in the postoperative period was notably reduced in PRP group. PRP also remarkably hastened the donor site healing. Conclusion: The application of PRP promotes graft take, minimizes complications, enhances donor site wound healing, mitigates donor site pain, and has immense economic benefits due to the reduced number of dressing changes and shorter hospital stay. © 2023 Journal of Cutaneous and Aesthetic Surgery.
Evaluation of axillary lymph nodes in breast cancer patients with clinically negative axilla using contrast enhanced ultrasonography
(BioMed Central Ltd, 2024) Roshit Jain; Rahul Khanna; Ashish Verma; Shashi Prakash Mishra; Ram Niwas Meena; Seema Khanna; Siddharth Khanna
Contrast enhanced ultrasonography enables dynamic evaluation of the microvasculature down to the capillaries when using high resolution ultrasound probes. It’s application in the evaluation of axillary lymph nodes in breast cancer patients with clinically negative axilla has been studied in 42 patients. The results of pre operative CEUS evaluation was correlated with histopathology status of axillary nodes after the harvesting of nodes during modified radical mastectomy or sentinel node biopsy. Heterogeneous enhancement with micro bubbles of the axillary nodes was found to be the most distinguishing criteria for malignant nodes. © The Author(s) 2024.