Browsing by Author "S.P. Sharma"

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A comparative study of intratumoral chemotherapy in advanced childhood common solid tumors
(Medknow Publications and Media Pvt. Ltd, 2007) Rajeev Rahi; K. Vijyendra; S.P. Sharma; N.C. Aryya; R.C. Shukla; S. Pradhan; T.B. Singh; A.N. Gangopadhyay
Background: Advanced and inoperable solid tumors in children are great killer despite aggressive multimodality treatment. Intravenous chemotherapy, due to high dose of drug given systemically, at times leads to abandonment of therapy due to systemic toxicities. To overcome this problem lots of studies are going on to explore alternative modes of giving anticancer drugs so as to decrease the systemic toxicities of the drugs and increase their therapeutic index at the same time. Aim: The study was conducted to know the results of anterior intratumoral chemotherapy and its comparison to anterior intravenous chemotherapy. Materials and Methods: Forty patients of advanced inoperable solid tumors in children (Wilms′ tumor and neuroblastoma) between 2000-2004 were randomly allocated to two groups. Group A (20 patients) was given intratumoral chemotherapy while Group B (20 patients) was given intravenous chemotherapy. Both the groups were compared in terms of reduction in size and volume, resectability of tumor, histopathological changes and side-effects of chemotherapeutic drugs. The Institute′s ethics committee approved this study. Results: Males were predominant in both type of cases (Wilms′ tumor and neuroblastoma) in both the groups (Group A and Group B). Mean age in the study was 3.27 years. All cases in Group A had Stage III disease except three cases which had Stage IV disease (one case of Wilms′ tumor and two cases of neuroblastoma) while in Group B only two cases had Stage IV disease (one case of Wilms′ tumor and one case of neuroblastoma). Intratumoral chemotherapy was found to be superior over intravenous chemotherapy in terms of reduction of size and volume (63% in Group A vs. 22% in Group B). The resectability was 70% in the intratumoral group in comparison to 40% in the intravenous group. The overall good histopathological response was 71% in Group A as opposed to 0% in Group B. Moreover, the incidence and severity of side-effects of chemotherapy and morbidity was less in intratumoral chemotherapy. Mortality was also low in Group A (5%) in comparison to Group B (20%). Conclusion: In this study intratumoral chemotherapy was found to be superior over intravenous chemotherapy in terms of better and early tumor regression, minimal side-effects, better tumor resectability and well response on histopathological criteria. This study is still going on at our center where different drug combinations, different drug doses, their toxicities, their mechanisms of action, their serum levels and long-term results of intratumoral mode of chemotherapy are to be evaluated thoroughly in future.
A new variant of esophageal atresia with tracheoesophageal fistula and duodenal atresia: A diagnostic dilemma
(Springer Verlag, 1997) C.K. Sinha; A.N. Gangopadhyay; S.P. Sahoo; S. Chooramani Gopal; D.K. Gupta; S.P. Sharma
A new variant of esophageal atresia (EA) with tracheoesophageal fistula (TEF) associated with duodenal atresia is reported. The TEF was between the lower pouch and the trachea, with a cystic dilatation in the midportion. The tracheal end of the fistula was obstructed by a membranous septum at both ends of a cystic dilatation, leading to a diagnosis of pure EA (gasless abdomen). After the lower pouch was opened beyond the cystic dilatation, 100 ml nonbilious fluid was obtained. A laparotomy revealed a type III atresia of the first part of the duodenum.
A rare association of diphallus, colonic duplications, ileal atresia, and an anorectal malformation
(1996) S.P. Sharma; A.N. Gangopadhyay; D.K. Gupta; S. Chooramani Gopal; R.N. Dash; C.K. Sinha
Diphallus is a rare congenital anomaly that is often associated with various other anomalies of the midline structures of the posterior portion of the body. We report a unique case of a 1-day-old male with complete diphallus, incomplete bilateral tubular duplications of the colon, ileal atresia, and an anorectal malformation.
Abdominal cocoon in children: A report of four cases
(W.B. Saunders, 1996) S.P. Sahoo; A.N. Gangopadhyay; D.K. Gupta; S.C. Gopal; S.P. Sharma; R.N. Dash
Abdominal cocoon is a rare cause of intestinal obstruction. The authors report four cases (3 boys, 1 girl; age range, 6 to 8 years) that presented with features of intestinal obstruction. There was no history of previous surgery, peritonitis, or prolonged drug intake in any of these cases. One patient presented with acute intestinal obstruction and gangrene of bowel. The etiology, preoperative diagnosis, and management of this condition are discussed.
Abdominal tuberculosis in Indian children
(Springer Verlag, 1996) S.P. Sharma; A.N. Gangopadhyay; S.C. Gopal; D.K. Gupta; R. Yadav
During the period 1980-1991, 166 cases (121 surgically explored and 45 treated conservatively) of abdominal tuberculosis in children were encountered at the Children's Hospital, Institute of Medical Sciences, Banaras Hindu University. Various types of presentations and their management are discussed in the light of pertinent literature.
Acute gastric volvulus in neonates - A diagnostic dilemma
(2008) V.D. Upadhyaya; Ajay Narayan Gangopadhyay; A. Pandey; V. Kumar; S.P. Sharma; D.K. Gupta
Introduction: Gastric volvulus is a rare, potentially life-threatening condition, which is difficult to diagnose. This study presents a series of acute gastric volvulus in neonates with the aim of describing this rare disease and its varied clinical manifestations. Material and Methods: The data of all neonates presenting with acute gastric volvulus between January 2001 and January 2007 was retrospectively reviewed. Diagnosis was made on suspicion and was documented by a barium study. All patients were operated by open anterior gastropexy with or without a feeding gastrostomy. Results: Four patients were male and 1 was female. All were treated with gastropexy with or without feeding gastrostomy. Four patients recovered well after surgery. There was one postoperative death. Conclusion: Gastric volvulus is extremely rare in neonates but it should be considered in the differential diagnosis after sudden onset or recurrent vomiting in the pediatric age group. Early diagnosis and treatment gives excellent results. © Georg Thieme Verlag KG Stuttgart.
Adverse Drug Reactions Following Propranolol in Infantile Hemangioma
(Springer, 2021) Vaibhav Pandey; Preeti Tiwari; Mohammed Imran; Akash Mishra; Deepak Kumar; S.P. Sharma
Objectives: To assess the adverse effects of propranolol therapy in infantile hemangioma. Methods: An ambispective study was conducted from August 2011 to December 2019. In retrospective arm all children managed for infantile hemangioma with propranolol were included and case records were assessed for adverse reactions. In prospective arm the adverse reactions were identified on the basis of predefined criteria. Results: A total of 514 patients (358 retrospective records) were included. A majority, 378 (73.5%) patients had an excellent response, 75 (14.5%) had partial response and 61 (11.8 %) had no response. A total of 82 (15.9%) patients experienced at least one adverse effect. Diarrhea with weight loss (27, 32.9%) and irritability with decreased sleep (21, 25.6%) were the most common adverse effects. The adverse effects in 22 (4.2%) cases lead to the discontinuation of propranolol. Younger age, low body weight and early onset were risk factors for development of severe adverse reactions. Conclusion: Young children with low body weight were at higher risk for adverse effects of propranolol. © 2021, Indian Academy of Pediatrics.
Agenesis of the bladder: A rare clinical entity in a male child
(1993) S. Chooramani Gopal; A.N. Gangopadhyay; S.P. Sharma; S.K. Pandit; P.K. Sharma
Agenesis of the bladder, one of the rarest anomalies of the urinary bladder, was for the first time managed successfully by primary ileocecal functional bladder reconstruction at the Children's Hospital, Institute of Medical Sciences, Banaras Hindu University. The salient features along with a review of literature are presented. © 1993, Springer-Verlag. All rights reserved.
An unusual presentation of hydatid cyst in anterior abdominal wall
(Kathmandu University, 2008) Punit Srivastava; A.N. Gangopadhyay; V.D. Upadhyaya; S.P. Sharma; R. Jaiman
Hydatid disease is a parasitic infestation caused by the larval form of the cestode worm Echinococcus. The most commonly encountered form of the disease is visceral hydatid cyst caused by Echinococcus granulosus or dog tapeworm. Muscular involvement has been reported in only 3-4% cases. We are reporting this case because of its rarity, difficulty to diagnose clinically, dramatic response to medical treatment and to alert the reader of this rare infestation so that open biopsy will be avoided.
An unusual presentation of infantile gangrenous acalculous cholecystitis.
(1993) A.N. Gangopadhyay; S.K. Biswas; N.C. Arya; S.P. Sharma; S.C. Gopal
[No abstract available]
Anterior intratumoural chemotherapy: A newer modality of treatment in advanced solid tumours in children
(Elsevier (Singapore) Pte Ltd, 2008) A.N. Gangopadhyay; Rahi Rajeev; S.P. Sharma; Vijai D. Upadhyaya; N.C. Arya; Vijayendra Kumar; S.C. Gopal
OBJECTIVE: Advanced and inoperable solid tumours in children have high mortality despite aggressive multimodal treatment. Intravenous chemotherapy is abandoned at times because of systemic toxicity. This study investigated intratumoural chemotherapy and compared it with intravenous chemotherapy. METHODS: Forty children with advanced inoperable solid tumours (Wilms' tumour and neuroblastoma) were randomly allocated into two groups of 20. Group A was given intratumoural chemotherapy and group B was given intravenous chemotherapy. Both groups were compared for reduction in tumour size and volume, tumour resectability, histopathological changes and drug side effects. RESULTS: Intratumoural chemotherapy was superior to intravenous chemotherapy in terms of reducing tumour size and volume (63% in group A vs. 22% in group B). The resectability was 70% in the intratumoural group compared with 40% in the intravenous group. The overall good histopathological response was 71% in group A as opposed to 0% in group B. Moreover, the incidence and severity of drug side effects and morbidity were less with intratumoural chemotherapy. Mortality was also low in group A (5%) compared to group B (20%). CONCLUSION: Intratumoural chemotherapy can be offered as an effective and safe alternative treatment modality for advanced and inoperable Wilms' tumour and neuroblastoma. [Asian J Surg 2008; 31(4):225-9] © 2008 Elsevier.
Assessment and comparison of fecal continence in children following primary posterior sagittal anorectoplasty and abdominoperineal pull through for anorectal anomaly using clinical scoring and MRI
(W.B. Saunders, 2016) A.N. Gangopadhyay; Vaibhav Pandey; D.K. Gupta; S.P. Sharma; Vijayendar Kumar; Ashish Verma
Introduction We aimed to compare and contrast these main surgical procedures for ARM in terms of structural outcome through pelvic MRI & functional outcome through Kelly's scoring. Material and method A prospective study was conducted from August 2011 to July 2013 including all the cases of ARM managed in single stage (operated by one surgeon, first author) since 1995 that came for follow up at age of 3 years or more. Patients were divided in three groups: Group 8.A, PSARP (60 patients); Group B, Abdomino-PSARP (40 patients); and Group C, APPT (40 patients). The functional assessment of anal continence was carried out at the age of 3 years or more using Kelly's method. Structural assessment was done by 1.5-T Magnetic Resonance Imaging (MRI). Results In 24 patients with rectobulbar fistula, 71.5% of Group A patients had good continence. In 50 patients with rectoprostatic fistula, 73.7% of Group A, 70% of group B and only 36% of Group C had good outcomes. Better development of each muscle was associated with better outcomes in terms of anal continence (P = 0.001). Conclusion There is better outcome with PSARP and Abdomino-PSARP in patients with rectobulbar and rectoprostatic fistula. MRI is a valuable modality for postoperative structural analysis of patients with ARM and is also useful for predicting the long term functional outcome of these cases. © 2016 Elsevier Inc. All rights reserved.
Atresia of ileocecal junction, ileocecal valve: Rare variants of bowel atresia
(2009) Punit Srivastava; A.N. Gangopadhyay; D.K. Gupta; S.P. Sharma; Vijay D. Upadhyaya; Vijayendra Kumar; Richa Jaiman
Atresia of ileocecal junction and isolated atresia of ileocecal valve are rare types of intestinal atresia with very few reports in literature. We report two such cases. Radiology showed dilated ileal segment and distal micro colon in both the cases. At laparotomy there was atresia of ileocecal junction in the first case and isolated ileocaecal valve atresia with normal ileocecal junction in the other case. Both the babies were managed by ileocolic resection with an end to end anastomosis. The prognosis of ileocecal atresias is satisfactory.
Bleomycin sclerotherapy in lymphangiomas of the head and neck region: a prospective study
(Churchill Livingstone, 2021) P. Tiwari; V. Pandey; R.N. Bera; S.P. Sharma; N. Chauhan
Intralesional sclerotherapy for lymphatic malformations (LMs) has become a modality of choice because of the high morbidity and recurrence rates with surgical excision. Traditionally, the macrocystic variant has shown good results with sclerotherapy. This prospective study was performed to evaluate the role of bleomycin sclerotherapy in the management of different radiological variants of LM. A total of 142 patients were included in this study. The lesions were classified as macrocystic, microcystic, or mixed LMs on the basis of ultrasonography. All patients were managed by intralesional injection of bleomycin and were recalled after 4 weeks for evaluation. Colour photographs of the patients were taken before the onset of treatment and at each monthly visit, and were utilized to assess the response. Following the second, third, and fourth doses, the response was better in patients with the macrocystic variant than in those with the other two variants. However, after the completion of six doses, 80.3% of patients with the macrocystic variant, 67.4% with the microcystic variant, and 71.4% with the mixed type had a complete response. There was no difference in the overall response between the three types (P = 0.28). Oedema, erythema, and local induration with fever were the most common adverse effects and were more common in younger children. © 2020 International Association of Oral and Maxillofacial Surgeons
Chronic bilious vomiting in children in developing countries due to high bowel obstruction: Not always malrotation or tuberculosis
(2010) Anand Pandey; V. Kumar; A.N. Gangopadhyay; S.P. Sharma; S.C. Gopal; D.K. Gupta; S.C.U. Patne
Background: Bilious vomiting, in conjunction with abdominal pain is considered to be a surgical problem, unless proved otherwise. In children, besides tuberculosis (TB), we have found jejunal stricture (JS) due to non-specific jejunoileitis (NSJI) to be an important cause of chronic high small bowel obstruction and bilious vomiting. Materials and methods: In this retrospective study, the records of all children with complaint of intermittent bilious vomiting and failure to thrive were evaluated. Investigations included oral contrast study, ultrasound abdomen, chest X-ray and Mantoux test. Final confirmation was made at laparotomy. Treatment included jejuno-jejunal resection and anastomosis. Histopathology of the specimen was done to look for caseation, granuloma formation and other details. Results: Out of total 100 patients with the complaint of bilious vomiting, 25 were having JS. Radiologic confirmation was possible in 19 (76%) patients of JS. No patient had evidence of TB as per our protocol. Histopathology revealed non-specific ischemic changes in all specimens. Conclusion: Jejunal stricture due to NSJI is a common entity in our setup leading to bilious vomiting. Contrast study can provide high index of suspicion in most of the patients. The diagnosis must be confirmed after proper histopathological examination. The results of the surgery are excellent. © 2009 Springer-Verlag.
Chylolymphatic mesenteric cyst: An unusual abdominal mass in a new born
(Springer India, 1993) K. Panjwani; A.N. Gangopadhyay; S.P. Sharma; D.K. Gupta; Gopal S. Chooramani
[No abstract available]
Conservative treatment for round worm intestinal obstruction
(2007) A.N. Gangopadhyay; Vijai D. Upadhyaya; D.K. Gupta; S.P. Sharma; Vijayendra Kumar
Objective. The ascariasis is one of the most cosmopolitan intestinal parasite infections and it can be in inhospitable regions inhabited by human being, but its biggest prevalence is observed in the tropical and subtropical areas. Intestinal obstruction has been estimated to occur in 2 per 1000 ascaris-infected children per year. We are presenting a study emphasizing the conservative treatment for complete intestinal obstruction due to roundworms without sign and symptom of peritonitis and perforation. Methods. A total of 22 patients of roundworm obstruction partial or complete without signs of and symptoms of peritonitis were admitted in the Department of Pediatric Surgery IMS, BHU Varanasi India in the period form 2003 - 2005. Patients were put nil by mouth, intravenous fluid, antibiotics, piperazine salt through nasogastric tube and glycerine + liquid paraffin emulsion enemas and were evaluated for duration of hospital stay, rate of conversion to surgical treatment and complications. Results. 19 (86%) patients were treated successfully with conservative line of management. Only 3 patients required surgical intervention. No mortality, complication and mean hospital stay was 4.1 days (range 4 - 5 days). Conclusion. Round worm intestinal obstruction can be effectively treated by conservative line of management. © 2007 Dr. K C Chaudhuri Foundation.
Development of a biomarker of efficacy in second-line treatment for lymphangioma of the tongue: a pilot study
(Churchill Livingstone, 2019) V. Pandey; P. Tiwari; S.P. Sharma; R. Kumar; P. Panigrahi; O.P. Singh; S. Patne
Lymphangioma of the tongue is a rare lymphatic malformation, and various authors have reported the successful use of sirolimus for its treatment. However, the safety of sirolimus in children needs further evaluation so that those who do not respond are not necessarily exposed to its potential adverse effects. We hypothesised that assessment of lymphangiogenesis can be used to predict whether the patient will respond to sirolimus, so we organised a prospective study after ethics committee approval had been given. After clinical and histological diagnoses of lymphangioma of the tongue had been confirmed, 16 patients were given sirolimus 0.8 mg/day in three divided doses. Clinical response was assessed and compared with lymphatic microvessel density (LMVD), which was calculated immunohistochemically using the monoclonal antibody D2-40 as the lymphatic endothelial marker. Nine patients responded well, five partially, and two failed to respond. Mean (SD) LVD among the good responders was 21.00 (3.74), whereas among non-responders it was 8.00 (4.24). There was a significant difference in mean LVD between good responders, partial responders, and non-responders (p = 0.04). Sirolimus is effective in treating children with lymphangioma of the tongue, and lymphangiogenesis is a useful therapeutic predictive marker. © 2019 The British Association of Oral and Maxillofacial Surgeons
Dog bite of the prolapsed rectum in a child
(1993) S. Chooramani Gopal; A.N. Gangopadhyay; S.K. Pandit; S.P. Sharma; P.K. Sharma
A case of a dog bite of the massively prolapsed rectum in a 2-year-old male is reported due to its rarity. © 1993, Springer-Verlag. All rights reserved.
Double coin in esophagus at same location and same alignment - A rare occurrence: A case report
(2009) Eti V. Upadhyaya; Punit Srivastava; Vijay D. Upadhyaya; A.N. Gangopadhyay; S.P. Sharma; D.K. Gupta; Zaheer Hassan
Coin is the most common foreign body swallowed by pediatric age group. The multiple coin swallowing is extremely rare and very few cases had been reported in English literature. Most of them were present at different site and had different alignment in the esophagus. The location of the coin (trachea vs. esophagus) is commonly determined by the alignment of the coin on radiographic studies. A 4-year-girl was presented to us with history of coin ingestions one day back without any respiratory distress. On radiological study there was suspicion of two coins on same location and alignment. The diagnosis was confirmed after removal. The both coin was removed successfully by esophagoscopy. Unexpected second foreign bodies in pediatric esophageal coin ingestions are rare and it is mandatory to do post operative radiography after removal to exclude duplex coin or tracheal coin. We are presenting this case because of its rarity, difficulty in diagnosis especially when proper history is not available. © 2009 Upadhyaya et al; licensee Cases Network Ltd.