Browsing by Author "V.K. Shukla"

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A 20-year-old woman with a painful swollen left thumb.
(2006) S.K. Tiwary; M.K. Singh; R.C. Shukla; M. Pandey; V.K. Shukla
[No abstract available]
A clinico-epidemiological profile of non-healing wounds in an Indian hospital.
(2000) S.K. Saraf; V.K. Shukla; P. Kaur; S.S. Pandey
One hundred patients with non-healing wounds of more than six weeks' duration were studied for clinico-epidemiological factors and their correlation with healing time. The majority of subjects were aged 30-59 years; those aged 50 and over had significantly delayed healing. Most of the subjects were farmers and physical labourers. Leprosy was the most common cause of non-healing wounds, followed by diabetes, trauma and venous ulcers; the lower limbs were the most common site of involvement. Diabetic wounds were more common in those aged 40 years and above. Diabetic wounds were slower to heal than others. The time to healing was calculated from the day subjects received treatment advice at the wound clinic. Seventy-five of the study group were included for calculation of healing time. The others were lost to follow-up or excluded for other reasons.
A Phase II study of gemcitabine and cisplatin in chemotherapy-naive, unresectable gall bladder cancer
(2004) D.C. Doval; J.S. Sekhon; S.K. Gupta; J. Fuloria; V.K. Shukla; S. Gupta; B.S. Awasthy
The primary objective of this study was to determine the response rates of the gemcitabine and cisplatin combination in unresectable gall bladder cancer patients. The secondary objectives were to evaluate the toxicity, time to progressive disease, and overall survival. Chemonaïve patients with histologically proven, unresectable bidimensionally measurable gall bladder cancer were enrolled into this study. All patients were required to have a Zubrod's performance status ≤2, no prior radiotherapy, and adequate major organ function. Patients received gemcitabine (1000 mg m-2 intravenously over 30-60 min) on days 1 and 8, and cisplatin (70 mg m -2 intravenously over 2h) on day 1, every 21 days. Response assessment was done by a CT scan after every other cycle of chemotherapy. In all, 30 patients were eligible for efficacy and toxicity analysis. There were four (13.3%) complete responders, seven (23.3%) partial responders, and seven (23.3%) with stable disease, with four (13.2%) patients showing disease progression. The median time to progression was 18 weeks (95% confidence interval (CI) 14-24 weeks), and the median duration of response was 13.5 weeks (range 5.5-104 weeks). The median overall survival was 20 weeks (95% CI 14-31 weeks), with 1-year survival rate of 18.6%. WHO grade 3 or 4 anaemia was seen in seven (23.3%) and four (13.3%) patients, respectively. Five (16.6%) patients each experienced grade 3 or 4 neutropenia, and grade 3 or 4 thrombocytopenia was seen in three (10%) and two (6.6%) patients, respectively. The present study shows that gemcitabine/cisplatin combination is well tolerated and active in advanced unresectable gall bladder cancer. © 2004 Cancer Research UK.
A trial to determine the role of placental extract in the treatment of chronic non-healing wounds.
(2004) V.K. Shukla; M.A. Rasheed; M. Kumar; S.K. Gupta; S.S. Pandey
OBJECTIVE: To investigate the effect of topical placental extract in the treatment of non-healing wounds. METHOD: One hundred patients attending the wound clinic at University Hospital, Varanasi, India, with wounds of more than six weeks' duration were recruited. Fifty patients were treated with placental extract, and 50 were controls. Wound biopsy and swab culture and sensitivity were performed and the area surrounding the wound was X-rayed. Wound size was measured and the rate of epithelialisation assessed at weekly follow-ups. In nine cases biopsies were repeated after two weeks of treatment and sent for histopathological examination, including angiogenesis. RESULTS: Thirty patients dropped out, leaving 40 cases in the treatment group and 30 in the control group. Over an eight-week period, 27 patients (67.5%) in the treatment group showed more than 50% epithelialisation, compared with only seven patients (23.3%) in the control group. CONCLUSION: Placental extract has a beneficial role to play as a topical agent in the management of chronic non-healing wounds.
A yellow patient with hepatomegaly
(BMJ Publishing Group, 1999) O.P. Mishra; Mohan Kumar; V.K. Dixit; V.K. Shukla
[No abstract available]
Abdominal compartment syndrome--an old syndrome, a new perspective.
(2007) Puneet; V. Chauhan; S. Singh; S.K. Gupta; V.K. Shukla
The abdominal compartment syndrome is a life threatening condition resulting from pathologic elevation of the intraabdominal pressure. Prompt diagnosis is required to avoid significant sequelae. Diagnosis of this syndrome is based on clinical findings and intra abdominal pressure monitoring. Treatment consists of decompressive laparotomy, which corrects the pathology. Various surgical techniques are described to manage the open abdomen. Despite considerable attention accorded to this disorder, it is still associated with high morbidity and mortality. This review article deals with the identification of risk factors, pathophysiology, diagnostic criteria and treatment of critically ill patients with the abdominal compartment syndrome.
ABO and Rh blood groups in patients with cholelithiasis and carcinoma of the gall bladder
(1995) M. Pandey; A. Gautam; V.K. Shukla
[No abstract available]
Adrenal tumors: An experience of 10 years in a single surgical unit
(Medknow Publications, 2015) S. Khanna; R. Priya; S.K. Bhartiya; S. Basu; V.K. Shukla
INTRODUCTION: Most of the adrenal masses are discovered incidentally by imaging techniques for reasons unrelated to adrenal diseases. Treatment is based on various factors such as, nature of adrenal mass, age of presentation, size of tumor, and the functional status of tumor. We report a series of 14 consecutive cases of adrenal tumors treated in a single surgical unit in our hospital. AIM: The aim of this study was to evaluate the clinical profile and outcome of treatment of adrenal tumors treated in a surgical unit. MATERIALS and METHODS: It is a retrospective study data of 14 cases of adrenal tumors treated in a single surgical unit in University Hospital over 10 years have been analyzed. Various parameters such as gender, age, size of tumor, functional status, histopathology, type of management, and outcome have been reviewed. Results: A total of 14 patients with adrenal masses were seen over a 10 year period (1997-2006). All were referred cases, either from endocrinology or medicine wards. There were seven female and seven male patients. Mean age of patients was 48.6 years (range 14-60 years). Mean size of tumor was 8.0 cm (5.9 cm for benign tumors and 9.7 cm for malignant tumors). There were six cases of adrenal carcinoma, four cases of adrenal myelolipoma, two cases of pheochromocytoma, and one each case of adrenal hyperplasia and histoplasmosis. There were only two functional tumors. All, except two malignant cases were treated operatively. A total of 5 year survival was 100% in benign cases and 27% in malignant tumors. CONCLUSION: Adrenal tumors need to be assessed for their functional status and malignant potential prior to treatment. Surgical excision is usually curative for benign lesion. Among malignant tumors the benefits of surgery depend on local extent and metastatic status of tumors.
Aetiopathogenesis of carcinoma gallbladder.
(2001) V.K. Dixit; S. Singh; V.K. Shukla
[No abstract available]
An Indian community-based epidemiological study of wounds.
(2004) N. Gupta; S.K. Gupta; V.K. Shukla; S.P. Singh
OBJECTIVE: To establish the prevalence of wounds in a community, with an emphasis on chronic lower extremity wounds, and to identify the various aetiological factors involved. METHOD: A cross-sectional study was conducted to screen the population of two nearby communities (one urban and one rural) in India for wounds. This involved conducting a door-to-door survey between July 2001 and February 2003. RESULTS: The prevalence of wounds in the population studied (n = 6917) was 15.03 per 1000.The prevalences of acute and chronic wounds were 10.55 and 4.48 per 1000 of the population respectively. CONCLUSION:The most common site for both acute and chronic wounds was the lower extremity. In contrast to Western studies, the most common aetiology for a chronic lower extremity wound was an untreated acute traumatic wound. This in turn highlights the need to establish community-based wound-care teams in India.
An ultrasonographic evaluation of gallbladder emptying in patients with cholelithiasis
(2000) M. Agarwal; A.K. Agarwal; S. Singh; V.K. Shukla
Impaired gallbladder emptying producing biliary stasis may provide potent carcinogen, which comes in contact with gallbladder mucosa for a prolonged period, inducing carcinogenesis. The aim was to study gallbladder emptying pattern in cholelithiasis. Postprandial gallbladder emptying was measured ultrasonographically in terms of fasting volume (FV), postprandial residual volume at 30 minutes (PP30), 60 minutes (PP60), and 90 minutes (PP90), residual fraction, and ejection volume (EV) in 58 patients with gallstones. Patients were divided into two groups of poor and good contractors on the basis of 50% maximal postprandial gallbladder emptying. Malonaldehyde level was estimated in 15 patients with cholelithiasis. Twentynine patients (50%) were poor contractors. The FV in patients with cholelithiasis (mean, 30.08 mL) was larger than the controls (mean, 17.55 mL) and the difference was statistically significant (p < 0.02). The FV in the cholelithiasis group correlated significantly with the PP30 (r = 0.85, p < 0.001), PP60 (r = 0.85, p < 0.001), PP90 (r = 0.78, p < 0.001), and EV (r = 0.65, p < 0.001). Ejection volume was significantly less in poor contractors (p <0.001). Residual fraction was significantly higher in poor contractors (p < 0.001). The biliary malonaldehyde in poor contractors (2.27 μmol/mL) was higher than in good contractors (1.78 μmol/mL), but the difference was statistically not significant. Significantly larger volumes of PP30, PP60, PP90, and residual fraction and a low EV indicate poor contraction leading to biliary stasis.
An Unusual Presentation of Primary Chondrosarcoma of Bone
(Indian Medical Association, 1998) N.C. Aryya; M. Pandey; A. Gautam; V.K. Shukla
[No abstract available]
Analysis of Wide Modified Rankin Score Dataset using Markov Chain Monte Carlo Simulation
(Lifescience Global, 2024) Pranjal Kumar Pandey; Priya Dev; Akanksha Gupta; Abhishek Pathak; V.K. Shukla; S.K. Upadhyay
Brain hemorrhage and strokes are serious medical conditions that can have devastating effects on a person’s overall well-being and are influenced by several factors. We often encounter such scenarios specially in medical field where a single variable is associated with several other features. Visualizing such datasets with a higher number of features poses a challenge due to their complexity. Additionally, the presence of a strong correlation structure among the features makes it hard to determine the impactful variables with the usual statistical procedure. The present paper deals with analysing real life wide Modified Rankin Score dataset within a Bayesian framework using a logistic regression model by employing Markov chain Monte Carlo simulation. Latterly, multiple covariates in the model are subject to testing against zero in order to simplify the model by utilizing a model comparison tool based on Bayes Information Criterion. © 2024 Pandey et al.; Licensee Lifescience Global.
Anatomical basis for the clinical application of the arterial supply of musculus pectoralis major
(1991) S.K. Pandey; F.M. Tripathi; V.K. Shukla; C.B. Tripathi; J. Sonoo
The pattern of arterial supply to the various parts (clavicular, sternocostal and aponeurotic) of the pectoralis major muscle was studied in 7 cadaver dissections and 10 angiograms by injecting a radio-opaque substance. Three main arteries supplied the muscle, i.e. the pectoral branch of the thoracoacromial trunk (TAT-PB), the lateral thoracic artery and the perorating branch of the internal thoracic artery, supported by other branches of the TAT and the superior thoracic artery. It is observed that the TAT-PB, a chief vascular pedicle, anastomoses freely with other arteries and supplies most parts of the muscle. The present study is mainly focussed on the exclusion of the chief vascular pedicle of muscle to eliminate the confusion of previous studies and prevent the unnecessary hindrance and complications of the muscle flap.
Anatomical variations in termination of the axillary artery and its clinical implications
(SAGE Publications Ltd, 2004) S.K. Pandey; A.N. Gangopadhyay; S.K. Tripathi; V.K. Shukla
Variations in the termination of the axillary artery (AA) were observed in 51 out of 356 axilla during routine dissections. The incidence of variation was higher on the right axilla in 17.42% cases (CI: 11.60-22.51) than the left axilla 11.24% cases (CI: 6.46-15.55) and was found to be 12.33% in male and 40.63% in female cadavers. The variations were divided into four groups. The first group showed that the terminal end of the AA divided into lateral and medial divisions in 6.16% (CI: 2.21-9.82) male and in 15.63% (CI: 2.76-25.25) female cadavers. The second group variation showed that the terminal end of the axillary artery divided into deep and superficial divisions in 2.74% (CI: 0.10-5.27) male and in 6.25% (CI: -1.87-13.13) female cadavers. The third group showed that the terminal end of the AA divided into three branches in 2.74% (CI: 0.10-5.27) male and in 6.25% (CI: -1.87-13.13) female cadavers. The fourth group showed the tapering of the terminal end of AA in 0.68% (CI: -0.63-1.99) male and 12.50% (CI: 0.97-21.46) female cadavers. The variable origin of the circumflex humeral, subscapular and profunda brachii arteries was also observed. These variations in the terminal end of the axillary artery are not only of significant clinical importance to orthopaedic and reconstructive surgeons but also have very significant medico-legal implications.
Anatomical variations of the cords of brachial plexus and the median nerve
(2007) S.K. Pandey; V.K. Shukla
The variations in formation, location, and courses of the cords of brachial plexus and the median nerve were studied in both axillae of 172 cadavers. The total prevalence of variation was 12.8% (CI, 7.6-17.4) and it was found in 13.2% (CI, 7.5-18) of male and in 10.7% (CI, -0.6-19.6) of female cadavers. These variations were divided into three groups. The first group was abnormal location of the cords, which was either posterolateral or anteromedial in relation to the axillary artery in 2.3% (CI, 0.1-4.5) cadavers. The lateral cord and the medial root of the median nerve had received communicating branches from the posterior cord in most of the cases of this group. The second group was absence of the posterior cord in 3.5% (CI, 0.7-6.1) of cadavers. The lateral and medial cords of this group were connected with the communicating branches, which had a course in front of the axillary artery. The third group was abnormal formation and course of the median nerve in 7% (CI, 3.1-10.6) of cadavers. In all cases of this group the medial root received communicating branch/branches either from the lateral or posterior cord. In eight (4.7%) cadavers, both roots of the median nerve were joined on medial side of the axillary artery to form a median nerve, which traveled medial to the artery. In four (2.3%) cadavers the roots of the median nerve did not join and both traveled separately anteromedial to the axillary and brachial arteries. This study indicates that all three cords and median nerve vary considerably in levels of origin, location and course in relation to the axillary artery and these variable cases were joined with the communicating branch/branches. The observed variations are of anatomical and clinical interest. These kinds of variations are more prone to injury in radical neck dissection and in other surgical operation of the axilla. © 2000 Wiley-Liss, Inc.
Anatomical variations of the splenic artery and its clinical implications
(2004) S.K. Pandey; S. Bhattacharya; R.N. Mishra; V.K. Shukla
The variations in orgin, course, and terminal branching pattern of the splenic artery were studied in 320 cadavers. The artery originated from the coeliac trunk in the majority of cadavers (90.6%), followed by abdominal aorta (8.1%), and other sights (1.3%). A suprapancreatic course of the artery was commonly observed (74.1%) followed by enteropancreatic (18.5%), intrapancreatic (4.6%), and retropancreatic (2.8%) courses. In two cases (0.63%) the proximal part of the splenic artery made a loop that was embedded in the substance of the pancreas, which is an interesting and rare finding. In five cases (1.5%) the proximal part of the artery divided into two or more branches that had suprapancreatic and enteropancreatic courses. The splenic artery divided into terminal branches in 311 (97%) cadavers. In nine (2.8%) cadavers it passed through the hilum of spleen without dividing. Two terminal branches were the most common (63.1%) followed by four (18.8%), six (9.7%), and more than six (5.6%) branches. The present study clearly indicates that there is variation in origin, course, and terminal distribution pattern of the splenic artery. The knowledge of these variations are of significant importance during surgical and radiological procedure of upper abdominal region to avoid any catastrophic complications. © 2004 Wiley-Liss, Inc.
Antioxidant property of Rubia cordifolia extract and its comparison with vitamin E and parabenzoquinone
(1995) Y.B. Tripathi; Savita Shukla; Mukta Sharma; V.K. Shukla
This report investigates the antioxidant properties of R. cordifolia extract for protection against lipid peroxidation and reduced glutathione (GSH) content in rat liver homogenate compared with vitamin E and parabenzoquinone (PBQ). R. cordifolia protects against depletion of glutathione in a dose and time dependent manner, an inverse correlation was observed between reduced glutathione depletion and malondialdehyde (MDA) formation. Interestingly, parabenzoquinone showed a better response than R. cordifolia on cumene hydroperoxide (CHP) induced malon‐dialdehyde (MDA) release but there was no response in the rate of reduced glutathione (GHS) depletion. Thus it appears that R. cordifolia is a potent antiperoxidative and antioxidant. The mechanism of action is different to that of vitamin E and parabenzoquinone (PBQ). Copyright © 1995 John Wiley & Sons, Ltd.
Biliary bile acids in cholelithiasis and carcinoma of the gall bladder
(1993) V.K. Shukla; S.C. Tiwari; S.K. Roy
The role of biliary deoxvcholate as an endogenous carcinogen and the possible association between cholelithiasis and the subsequent development of carcinoma of the gall bladder is unclear. This paper describes biliary bile acid analysis performed on three groups of patients, 10 with cholelithiasis, 10 with carcinoma of the gall bladder and 10 control patients. This is the first report of bile acid changes in carcinoma of the gall bladder. In these 30 patients the total bile acids concentration was highly variable (11.44-53.68 mg/ml). The mean ratio of primary to secondary bile acids was 3.5:1. This ratio was, however, significantly higher in cholelithiasis than in the control group (5.34:1; P 0.0011; patients with carcinoma of the gall bladder had significantly higher secondary bile acids (1:1; P 0.001). This is due to a marked increase in the secondary bile acids and indicates that raised biliary deoxycholate concentrations are present in patients with carcinoma of the gall bladder and therefore may well be a factor in carcinogenesis. © 1993 Rapid Communications of Oxford Ltd.
Biliary heavy metal concentrations in carcinoma of the gall bladder: Case-control study
(BMJ Publishing Group, 1998) V.K. Shukla; A. Prakash; B.D. Tripathi; D.C.S. Reddy; S. Singh
[No abstract available]