Browsing by Author "Siddharth Khanna"

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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.
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.
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.
Sacral Pressure Ulcer Management by Negative Pressure Dressing: a Randomized Open Label Study
(Springer, 2023) Irshad Ahmad; Rahul Khanna; Pradyot Prakash; Siddharth Khanna; Ram Niwas Meena
The treatment of sacral pressure sores is associated with a high rate of failure and recurrence. If inadequately treated, they severely compromise the quality of life and may herald a terminal event. The present study was undertaken to compare the efficacy of negative pressure wound therapy (NPWT) with conventional dressing treatment for sacral pressure sores. Over a 4-year period, 38 patients of grade III and IV sacral pressure sores were treated by either NPWT (22 patients) or conventional dressing (16 patients) method. Prior to application of NPWT, the wound was debrided and complete hemostasis achieved. The NPWT device was set to deliver a negative pressure of 125 mmHg with 7-min cycle (5 min on pump followed by 2 min off). The dressing was changed after 5 to 7 days. At the end of 3 months of treatment, 4 patients had died in each group. Of the 18 patients alive in NPWT group, 6 patients (33%) achieved complete healing and 9 (50%) had wound size reduction by more than 50%. The corresponding figures in the conventional dressing group were 1 (8%) and 4 patients (33%), respectively. NPWT was found to achieve superior clearance of slough, better generation of granulation tissue, and obliteration of ulcer crater compared to conventional dressing. The negative pressure led to faster reduction of bacterial load promoted angiogenesis and obtained a better rate of wound healing. Moreover, it resulted in a much cleaner and hygienic wound environment, reduced the nursing time in change of dressing, and significantly decreased patient discomfort. © 2022, Association of Surgeons of India.