Browsing by Author "Seema Khanna"

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A Comparative Evaluation of Topical Application Versus Perilesional Injection of Platelet-Rich Plasma in Diabetic Foot Ulcer
(SAGE Publications Inc., 2025) Digumarthi Asha Rani; Seema Khanna; Shashi Prakash Mishra; Sandip Kumar
Diabetic foot ulcer (DFU) is globally a major health burden predisposing to limb amputation. Among the various treatment modalities, platelet-rich plasma (PRP) is emerging as a promising agent. It stimulates wound healing by providing a higher concentration of essential growth factors locally. Though the role of PRP in DFU healing is established, still the route of administration with maximal efficacy is yet to be defined. Our study aims to evaluate the efficacy of autologous PRP in the treatment of diabetic ulcers and compare the effect of topical and perilesional injections of PRP in DFU healing. We conducted a single-centre, prospective, interventional study on 60 patients with DFU, in 2 groups of 30 patients each. They were treated with freshly prepared autologous PRP injection perilesionally and topically respectively, once a week for 4 weeks. Ulcer size was assessed, using “imito-measure” software at presentation and 2, 4, 8, and 12 weeks post-therapy. Serum MMP-9 levels were assessed in both groups, pretreatment and post-treatment. For statistical analysis, SPSS software V-23 was used. On assessment, both groups had comparable baseline characteristics, Wagner's grading, and glycemic indices. The percentage reduction in the size of the wound at 2 weeks, 1 month, 2 months, and 3 months was greater in the perilesional group as compared to the topical PRP group. © The Author(s) 2023
A Comparative Evaluation of Topical Application Versus Perilesional Injection of Platelet-Rich Plasma in Diabetic Foot Ulcer
(SAGE Publications Inc., 2023) Digumarthi Asha Rani; Seema Khanna; S.P. Mishra; Sandip Kumar
Diabetic foot ulcer (DFU) is globally a major health burden predisposing to limb amputation. Among the various treatment modalities, platelet-rich plasma (PRP) is emerging as a promising agent. It stimulates wound healing by providing a higher concentration of essential growth factors locally. Though the role of PRP in DFU healing is established, still the route of administration with maximal efficacy is yet to be defined. Our study aims to evaluate the efficacy of autologous PRP in the treatment of diabetic ulcers and compare the effect of topical and perilesional injections of PRP in DFU healing. We conducted a single-centre, prospective, interventional study on 60 patients with DFU, in 2 groups of 30 patients each. They were treated with freshly prepared autologous PRP injection perilesionally and topically respectively, once a week for 4 weeks. Ulcer size was assessed, using “imito-measure” software at presentation and 2, 4, 8, and 12 weeks post-therapy. Serum MMP-9 levels were assessed in both groups, pretreatment and post-treatment. For statistical analysis, SPSS software V-23 was used. On assessment, both groups had comparable baseline characteristics, Wagner's grading, and glycemic indices. The percentage reduction in the size of the wound at 2 weeks, 1 month, 2 months, and 3 months was greater in the perilesional group as compared to the topical PRP group. © The Author(s) 2023.
A rare presentation of abdominal castleman disease: A case report
(SAGE Publications Inc., 2024) Seema Khanna; D.A. Rani; S. Kumar; S.K. Gupta
Unicentric Castleman disease (UCD) is a rare benign lymphoid proliferative disease having solitary or multiple lesions in adjacent organs, limited to the same lymphoid region. Among all the affected stations, mesenteric localization of UCD is very rare and often misdiagnosed due to the absence of typical clinical and imaging features, making preoperative diagnosis difficult. Complete surgical resection remains the standard of care, which shows curative intent in 90% of patients. We report a rare case of an adolescent male with abdominal UCD who presented with intermittent abdominal pain, vomiting, and a firm, mobile lump in the right lower abdomen. Hematological parameters were within normal limits. Ultrasound raised suspicion of mesenteric mass in the right paraumbilical region which on contrast-enhanced CT scan was suggestive of benign mesenteric mass/desmoid tumor. Intraoperatively, a 10 × 9 cm mesenteric mass was noted in the right paraumbilical region attached to root of mesentery along with an inflamed appendix. Excision of the mesenteric mass with appendectomy was done. Histopathology was suggestive of Angio Follicular Lymphoid Hyperplasia (Castleman disease) and inflamed appendix. Castleman disease is an unusual medical case that poses a diagnostic challenge and it must be included in the differential diagnoses of solid abdominal mass. Though multiple treatment options are available, surgical resection is still considered the standard treatment of choice due to its diagnostic and therapeutic advantages. © The Author(s) 2024.
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.
Association between biomarkers of oxidative stress, trace elements, and cell proliferation index in patients with benign and malignant breast diseases
(Begell House Inc., 2015) Kanchan Karki; Deepti Pande; Reena Negi; Seema Khanna; Ranjana S. Khanna; Hari D. Khanna
Objectives: To understand the association between biomarkers of oxidative stress, antioxidants, trace elements, and cell proliferation index in relation to the disease progression in the pathophysiology of breast diseases. Design and Methods: Concentrations of markers of oxidative stress, antioxidants, trace elements, and cell proliferation index were evaluated in the patients with benign breast diseases, malignant breast diseases, and healthy volunteers as controls. Multinomial logistic regression analysis was used to identify the contribution of the selected indexes using odds ratio and associated confidence interval. Results: The level of markers of oxidative stress (malondialdehyde [MDA]) and cell proliferation index were found to be significantly higher with significantly depleted levels of antioxidants and trace elements in breast cancer patients compared with control subjects as well as benign breast disease patients. A similar pattern of changes were observed between benign and control subjects. Conclusion: An inadequate amount of antioxidant enzymes and trace elements may be an important contributing factor associated with oxidative stress leading to elevated levels of MDA and cell proliferation index in relation to disease progression and clinical stage in the pathophysiology of breast diseases. © 2015 by Begell House, Inc.
Carcinoma in accessory axillary breast
(BMJ Publishing Group, 2015) Seema Khanna; Shashi Prakash Mishra; Satendra Kumar; Ajay Kumar Khanna
We present a rare case of carcinoma developing in an accessory breast. The patient presented with a progressive lump in her right axilla for 1 year. On examination, there was a well-developed nipple areola complex in the right axilla overlying a hard, fixed 5×3 cm lump. On investigation, core biopsy revealed poorly differentiated carcinoma of the breast. Mammography also revealed features of a malignant lesion with skin and muscle infiltration. Neoadjuvant chemotherapy was administered followed by modified radical mastectomy after three cycles. Immunohistochemistry study showed positive status of oestrogen and progesterone receptors, and negative HER-2 neu. Three more cycles of chemotherapy along with 50 Gy radiotherapy were given in an adjuvant setting followed by hormone therapy. Copyright 2015 BMJ Publishing Group. All rights reserved.
Case Report: a Rare Case of Bilateral Spigelian with Bilateral Inguinal Hernia
(Springer, 2021) Prakhar Jaiswal; Seema Khanna; Sanjeev K. Gupta; Satendra Kumar
Spigelian hernia is an uncommon hernia which occurs through a defect in the spigelian aponeurosis. An 84-year-old gentleman presented to us with uncomplicated bilateral spigelian hernia with bilateral direct inguinal hernia. The patient underwent an open pre-peritoneal mesh repair under spinal anesthesia. Bilateral spigelian hernia with bilateral inguinal hernia is a rare occurrence which led us to publish this case report. © 2020, Association of Surgeons of India.
Cleft palate associated with hamartomatous bifid tongue. Report of two cases
(2009) V. Bhattacharya; Seema Khanna; Sheikh Adil Bashir; Umesh Kumar; Rajendra S. Garbyal
Congenital tumours of the tongue may have a detrimental effect on the simultaneously developing adjacent structures. Palate formation may be affected as it develops in the same period of organogenesis as the tongue. We present two such rare cases of cleft palate with tumour of the dorsal tongue as the probable causative factor. To analyse such an entity, it is necessary to understand the embryogenesis of the palate and tongue. The management and possible elucidation of the occurrence with respect to the developmental phases of tongue and palate are detailed in brief. © 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons.
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.
Correlation of serum toll like receptor 9 and trace elements with lipid peroxidation in the patients of breast diseases
(Elsevier GmbH, 2015) Kanchan Karki; Deepti Pande; Reena Negi; Seema Khanna; Ranjana S. Khanna; Hari D. Khanna
Toll-like receptors are recognized as redox sensitive receptor proteins and have been implicated in cellular response to oxidative stress. Altered pro-oxidant-antioxidant balance leads to an increased oxidative damage and consequently play an important role in breast diseases. The study was designed to access the oxidative stress status by quantification of byproducts generated during lipid peroxidation and inadequate trace elements during oxidative damage and its effects on the toll like receptor (TLR) activity in patients of breast diseases. Decreased levels of selenium, copper, zinc, magnesium and iron with elevated levels of malondialdehyde (marker of lipid peroxidation) were accompanied by decreased TLR activity in patients of benign breast diseases as well as breast carcinoma. A similar pattern was observed with the advancement of disease and its subsequent progression in breast carcinoma patients. Results of multinomial regression analysis suggest benign breast disease patients are at higher risk of developing breast cancer with high odds ratio of lipid damage. © 2014 Elsevier GmbH.
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]
Diathermy Burn Ulcers
(Springer Nature, 2023) Seema Khanna
Electrosurgical units, also called as surgical diathermy are an integral part of any surgical operation theater. They are an indispensable tool for general surgery, all surgical super-specialties, gynecology, orthopedics, ophthalmology, otorhinolaryngology, dermatology, dentistry. Recent advancements in energy devices have led to the introduction of newer modalities such as ultrasound based scalpel device, feedback dependent auto shutdown devices, hybrid devices, radiofrequency ablators, and laser energy devices. However, electrosurgical units (ESU) remain the primary workhorse of the operating surgeon. The advent of laparoscopic surgery has led to further refinements of ESU equipment as well as appearance of newer aspects of safety issues and complications. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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.
Documentation of ulcer
(Springer India, 2016) Seema Khanna
[No abstract available]
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.
Epidemiological Study of Triple-Negative Breast Cancer Patients in North Indian Population: a Hospital-Based Study
(Springer India, 2017) Mekhla Gupta; Seema Khanna; Mohan Kumar; Amrita Ghosh Kar; S.K. Gupta
Triple-negative breast cancer (TNBC) accounts for 10–25% of all breast tumors. This makes it more difficult to treat, so triple-negative cancers often require targeted therapies. We studied the prevalence of TNBC in a hospital-based study and compared the clinicopathological characteristics of triple-negative and non-triple-negative breast tumors. One hundred three patients were included in the study that underwent modified radical mastectomy. The procedure of immunostaining was performed using formalin-fixed, paraffin-embedded tissue sections. These sections were stained immunohistochemically for ER, PR, and HER2 neu by using ready-to-use monoclonal antibody detection system with 3′-3′ diaminobenzidine hydrochloride (DAB) as chromogen. Of all 103 patients, 35 (34%) were triple negative. The average age of patients of TNBC and non-TNBC group was found as 44.16 and 40.73 years, respectively. Patients of post-menopausal state were higher than premenopausal in TNBC (22/35; 62%) and non-TNBC groups (45/68; 66%). Further, TNBC patients reported at clinically early stages I and II (18/35; 51.4%) while non-TNBC patients predominantly reported at later stages III and IV (44/68; 64.7%). It was also observed that breast tumor size in majority of the patients in both groups lies between 2 to 5 cm (TNBC = 23/35; 65.7% and non-TNBC = 35/68; 51.5%). Lymph node metastases were present in 51.5% (18/35) cases in TNBC patients and 64.7% (44/68) cases in non-TNBC group. Despite the limitation of less number of breast cancer cases, we analyzed that TNBC tumors have aggressive clinical values than non-TNBC, though having no statistically significant difference between the prognostic clinical parameters of two groups. © 2017, Indian Association of Surgical Oncology.
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.