Browsing by Author "Sanjeev Kumar Gupta"

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An introduction of tertiary peritonitis
(Medknow Publications, 2014) Shashi Prakash Mishra; Satyendra Kumar Tiwary; Manjaree Mishra; Sanjeev Kumar Gupta
Intraperitoneal infection known as peritonitis is a major killer in the practice of clinical surgery. Tertiary peritonitis (TP) may be defined as intra-abdominal infection that persists or recurs 48 h following successful and adequate surgical source control. A planned or on-demand relaparotomy after an initial operation is probably most frequent way to diagnose TP, but is a late event to occur. Hence it is desirable to have timely and nonoperative diagnosis of TP after the initial operation and subsequent initiation of an appropriate therapy to reduce the complications and to improve the outcome.
Basal Cell Carcinoma of the Extremity
(Springer Nature, 2023) Sanjeev Kumar Gupta
Chronic ulcers affecting the extremities have diverse etiology. These ulcers are more common in the lower extremity than in the upper extremity. The prevalence of lower extremity ulcers ranges from 0.18% to 2% but increases to 5% in patients older than 65 years [1]. Some of the common extremity ulcers include diabetic foot ulcers, ulcers of chronic venous disease, ischemic ulcers, chronic infections such as tuberculosis, autoimmune diseases, and malignant ulcers. Of the various types of ulcers mentioned above, malignant ulcers are relatively uncommon. These ulcers can be either primary or result from malignant transformation in a chronic ulcer. The prevalence of malignancy in chronic leg ulcers ranges from 2.0% to 4%. Squamous cell cancer (SCC) and basal cell cancer (BCC) are the most common ulcerating skin tumors. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
Cutaneous zygomycosis: A possible postoperative complication in immunocompetent individuals
(2009) Ragini Tilak; Prabhat Raina; Sanjeev Kumar Gupta; Vijai Tilak; Pradyot Prakash; Anil Kumar Gulati
Fungi in the class of zygomycetes usually produce serious infections in diabetics and immunocompromised hosts. Cutaneous zygomycosis is a less common form, with an unpredictable extent of anatomical involvement and clinical course. Here, we report two cases of primary cutaneous zygomycosis as postoperative complications in otherwise healthy females. Zygomycosis was suspected and specimens from the surgical debridement were examined by microbiological and histopathological studies for confirming the clinical diagnosis. Rapid diagnosis, liposomal amphotericin B, and proper debridement of affected tissue are necessary to avoid a fatal outcome.
Deciphering the landscape of triple negative breast cancer from microenvironment dynamics and molecular insights to biomarker analysis and therapeutic modalities
(John Wiley and Sons Inc, 2024) Harshita Tiwari; Swati Singh; Sonal Sharma; Priyamvada Gupta; Ashish Verma; Amrit Chattopadhaya; Brijesh Kumar; Sakshi Agarwal; Rajiv Kumar; Sanjeev Kumar Gupta; Vibhav Gautam
Triple negative breast cancer (TNBC) displays a notable challenge in clinical oncology due to its invasive nature which is attributed to the absence of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor (HER-2). The heterogenous tumor microenvironment (TME) of TNBC is composed of diverse constituents that intricately interact to evade immune response and facilitate cancer progression and metastasis. Based on molecular gene expression, TNBC is classified into four molecular subtypes: basal-like (BL1 and BL2), luminal androgen receptor (LAR), immunomodulatory (IM), and mesenchymal. TNBC is an aggressive histological variant with adverse prognosis and poor therapeutic response. The lack of response in most of the TNBC patients could be attributed to the heterogeneity of the disease, highlighting the need for more effective treatments and reliable prognostic biomarkers. Targeting certain signaling pathways and their components has emerged as a promising therapeutic strategy for improving patient outcomes. In this review, we have summarized the interactions among various components of the dynamic TME in TNBC and discussed the classification of its molecular subtypes. Moreover, the purpose of this review is to compile and provide an overview of the most recent data about recently discovered novel TNBC biomarkers and targeted therapeutics that have proven successful in treating metastatic TNBC. The emergence of novel therapeutic strategies such as chemoimmunotherapy, chimeric antigen receptor (CAR)-T cells-based immunotherapy, phytometabolites-mediated natural therapy, photodynamic and photothermal approaches have made a significant positive impact and have paved the way for more effective interventions. © 2024 Wiley Periodicals LLC.
Deciphering the landscape of triple negative breast cancer from microenvironment dynamics and molecular insights to biomarker analysis and therapeutic modalities
(John Wiley and Sons Inc, 2025) Harshita Tiwari; Swati Singh; Sonal Sharma; Priyamvada K. Gupta; Ashish Verma; Amrit Chattopadhaya; Brijesh Kumar; Sakshi Agarwal; Rajiv Kumar; Sanjeev Kumar Gupta; Vibhav Gautam
Triple negative breast cancer (TNBC) displays a notable challenge in clinical oncology due to its invasive nature which is attributed to the absence of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor (HER-2). The heterogenous tumor microenvironment (TME) of TNBC is composed of diverse constituents that intricately interact to evade immune response and facilitate cancer progression and metastasis. Based on molecular gene expression, TNBC is classified into four molecular subtypes: basal-like (BL1 and BL2), luminal androgen receptor (LAR), immunomodulatory (IM), and mesenchymal. TNBC is an aggressive histological variant with adverse prognosis and poor therapeutic response. The lack of response in most of the TNBC patients could be attributed to the heterogeneity of the disease, highlighting the need for more effective treatments and reliable prognostic biomarkers. Targeting certain signaling pathways and their components has emerged as a promising therapeutic strategy for improving patient outcomes. In this review, we have summarized the interactions among various components of the dynamic TME in TNBC and discussed the classification of its molecular subtypes. Moreover, the purpose of this review is to compile and provide an overview of the most recent data about recently discovered novel TNBC biomarkers and targeted therapeutics that have proven successful in treating metastatic TNBC. The emergence of novel therapeutic strategies such as chemoimmunotherapy, chimeric antigen receptor (CAR)-T cells-based immunotherapy, phytometabolites-mediated natural therapy, photodynamic and photothermal approaches have made a significant positive impact and have paved the way for more effective interventions. © 2024 Wiley Periodicals LLC.
Gossypiboma: Intramural and transmural migration causing small bowel obstruction
(2008) Santosh Kumar Mahalik; Puneet; Sanjeev Kumar Gupta; Ajay Kumar Khanna
[No abstract available]
Impact of ulceration
(Springer India, 2016) Sanjeev Kumar Gupta
[No abstract available]
Intramuscular myxoinflammatory fibroblastic sarcoma of the thigh
(Elsevier B.V., 2016) Shashikant C.U. Patne; Richa Katiyar; Sanjeev Kumar Gupta
[No abstract available]
Jejunojejunal Intussusception with Internal Herniation in the Stomach
(Springer India, 2014) Seema Khanna; Dinesh Kumar; Rahul Khanna; Sanjeev Kumar Gupta
Jejunojejunal intussusception with internal herniation of the stomach through a gastrojejunostomy stoma is one of the rarest complications of the previous gastric surgery. The incidence is reported to be less than 0.1 %. An elderly male presented to the emergency room with signs of intestinal obstruction for 1 day. There was also history of appearance of a lump in the mid-abdomen. A primarily healed midline scar of the previous surgery was present; the details of which were not known. X ray abdomen in the erect posture showed multiple air fluid levels. Ultrasonography (USG) revealed dilated stomach with central hyperechogenicity with a peripheral rim of decreased echogenecity. Contrast-enhanced computed tomography (CECT) scan showed jejunojejunal intussusception with internal herniation of the stomach. On laparotomy, it was found that there was a previous gastrojejunostomy with jejunal invagination leading to gangrene of a segment. Resection anastomosis was done. The postoperative period was uneventful. © 2012 Association of Surgeons of India.
Necrotizing soft tissue infections: Surgeon's prospective
(Hindawi Publishing Corporation, 2013) Shashi Prakash Mishra; Shivanshu Singh; Sanjeev Kumar Gupta
Necrotizing soft tissue infections (NSTIs) are fulminant infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Delay in diagnosing and treating these infections increases the risk of mortality. Early and aggressive surgical debridement with support for the failing organs significantly improves the survival. Although there are different forms of NSTIs like Fournier's gangrene or clostridial myonecrosis, the most important fact is that they share common pathophysiology and principles of treatment. The current paper summarizes the pathophysiology, clinical features, the diagnostic workup required and the treatment principles to manage these cases. © 2013 Shashi Prakash Mishra et al.
Primary squamous cell carcinoma of gallbladder presenting as acute cholecystitis
(2004) Sandeep Gupta; Sanjeev Kumar Gupta; N.C. Aryya
Primary squamous cell carcinoma of gall bladder accounts for only 0-12.7% of all cases of gall bladder cancer. We here report a case of primary squamous cell carcinoma of gall bladder presenting as acute cholecystitis. A 50 year old man was admitted with the complaints of pain in right hypochondrium and fever of 2 days duration. Abdominal examination revealed tenderness along with guarding and rigidity in right hypochondrium with positive Murphy's sign. The patient was conservatively treated as a case of acute cholecystitis. After 12 hrs of unrewarding treatment patient was operated upon and cholecystectomy done. The specimen revealed thick walled gall bladder with multiple calculi. Histopathology revealed squamous cell carcinoma grade II.
Prognostic biomarkers in triple negative breast cancer as a potential target for future drug discovery
(Innovare Academics Sciences Pvt. Ltd, 2017) Mekhla Gupta; Seema Khanna; Rajesh Kumar Singh; Sanjeev Kumar Gupta
Breast cancer is the most common malignancy in women globally, in which triple-negative breast cancer (TNBC) is more aggressive with poor prognosis and very less response to targeted hormone based treatment. It is a major cause of deaths among the women with breast cancer because of very few treatment options. The biomarkers could be a product of cancerous cell or molecule generated in response to cancer. It is used to understand the mechanism, prognosis, diagnosis as well as target for design and discovery of new drugs. The purpose of the study is to give a brief review on markers of TNBC. © 2017 The Authors.
Prospective validation of Bowel Injury Prediction Score for early diagnosis of surgically significant blunt bowel and mesenteric injury
(SAGE Publications Ltd, 2024) Shubham Kumar Gupta; Pramod Kumar Singh; Sumit Sharma; Sanjeev Kumar Gupta
Background: Blunt bowel and mesenteric injuries (BBMI) are frequently missed despite the widespread use of computed tomography (CT). Early diagnosis for timely management of surgically significant blunt bowel and mesenteric injuries (sBBMI) can be challenging. Several tools predictive for sBBMI have been proposed such as the “Bowel Injury Prediction Score” (BIPS) that is based on presence of abdominal tenderness, white blood cell count ≥17,000/mm3 and CT grade. The utility of this scoring system for early diagnosis of sBBMI has neither been studied in an Indian population nor prospectively validated. Methods: A single-centre prospective cohort study was conducted at a Trauma Centre in India. After screening of 1793 patients with blunt trauma abdomen who presented between 1st January 2022 and 31st August 2022 and underwent CT scan, eventually, 80 patients of age >18 years, hemodynamically stable and CT finding suspicious of BBMI were included. BIPS score was calculated. Patients were followed to evaluate the outcome. Results: The incidence of sBBMI was 3.06%. Mean age of study patients was 36.2 ± 16.5 years with male predominance (92.5%) and road traffic accidents the commonest mode of injury. Patients with BBMI were more likely to require operative intervention in the presence of abdominal tenderness at presentation (p < 0.01) and CT grade ≥4 (p < 0.01). For patients with WBC counts of ≥17,000/mm3, no statistically significant difference was noted in the need for operative intervention. BIPS ≥2 had 94.5% sensitivity, 72% specificity, 88% PPV, and 86% NPV for identifying patients with sBBMI. Conclusion: Calculation of BIPS at the time of presentation can avoid unnecessary delays in surgical management and thereby reduce overall morbidity and mortality even in an Indian setup. However, WBC counts > 17,000/mm3 were not found to be predictive of sBBMI. © The Author(s) 2023.
Reflections on Surgical Care in the Twenty-First Century—The Missing Elements in Surgical Training
(Springer, 2024) Shubham Kumar Gupta; Sanjeev Kumar Gupta; Ajay Kumar Khanna
[No abstract available]
Secretase inhibitors for the treatment of Alzheimer's disease: Long road ahead
(Elsevier Masson SAS, 2018) Devendra Kumar; Ankit Ganeshpurkar; Dileep Kumar; Gyan Modi; Sanjeev Kumar Gupta; Sushil Kumar Singh
Alzheimer's disease (AD) is a neurodegenerative disease, characterized by progressive loss of memory which is associated with other cognitive deficits. The two protein structures in the brain i.e. neurofibrillary tangles and senile plaques are considered to hamper the normal cognitive activity of the brain. There are various therapeutic interpolations under investigation to thwart and treat AD. Secretases inhibitors are important agents that inhibit the development of senile plaques. β-secretase (BACE) inhibitors are in lime light for the drug development of AD. BACE initiates the production of Aβ, so its inhibition provides a valid target for the AD. BACE inhibitors viz. LY2811376, LY2886721, E2609 are in different phases of clinical trials. However, chemical study of MK8931 was discontinued due to lack of chances of finding a positive clinical effect. Areas covered: The review incorporates exhaustive literature reports on secretase inhibitors, γ-secretase modulators (GSMs) and α-secretase enhancers. The recent studies on the natural products as GSMs have also been included. © 2018 Elsevier Masson SAS
Significance of Surgical Intervention in the Management of Diabetic Foot Infections
(Elsevier Inc., 2014) Shalbha Tiwari; Daliparthy Devi Pratyush; Sanjeev Kumar Gupta; Surya Kumar Singh
The incidence of diabetes is increasing at an alarming rate. Diabetic foot is a major cause of frequent hospital visits and extended stays. Both micro and macro-vascular abnormality play a role in its pathogenesis; i.e., it can be neuropathic or ischemic. Other factors such as impaired immunity, poor tissue reparative process and altered foot anatomy further deteriorate wound condition. Infection complicates the wound, delays healing and is a major cause of amputations. Infection control is the primary target for effective wound healing. This can be achieved by appropriate antibiotic selection and surgical intervention. Incision, drainage, debridement, revascularization and wound closure are the key surgical procedures for the management of diabetic foot infection. Careful evaluation of clinical and laboratory findings helps to determine the associated risk of organ involvement, complexity of the wound and severity of infection, as well as the timing of surgical interventions. This chapter provides an overview of diabetic foot infection and its management, with emphasis on surgical intervention. © 2014 Elsevier Inc. All rights reserved.
The etiopathogenesis of the diabetic foot: An unrelenting epidemic
(2010) Sanjeev Kumar Gupta; Satyajit Panda; Surya Kumar Singh
Diabetes mellitus is a metabolic disease that is associated with hyperglycemia affecting various organ systems of the body. One of the most dreaded complications of this disease is the diabetic foot. The diabetic foot is the end result of multiple causal pathways, which include peripheral neuropathy and vascular disease. The problem is compounded by the increased incidence of infection. This article deals with the various pathogenic pathways associated with the development of the diabetic foot. © The Author(s) 2010.
Tumor lysis syndrome: Correspondence
(Springer India, 2013) Vineeta Gupta; Sanjeev Kumar Gupta
[No abstract available]
Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection
(Cambridge University Press, 2014) Shalbha Tiwari; Daliparthy Devi Pratyush; Sanjeev Kumar Gupta; Surya Kumar Singh
Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration < 25 nmol/l) was more common in cases than in controls (48·2 v. 20·5 %). Although age, duration of diabetes, HbA1C (glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0·001), IL-1β (P≤ 0·02) and TNF-α (P≤ 0·006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r-0·323; P≤ 0·001) as well as IL-6 (r-0·154; P≤ 0·04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0·007) and IL-6 (P≤ 0·02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value < 25 nmol/l is suggested as the 'cut-off' for such immunological alterations in patients with diabetes mellitus. © 2014 The Authors.