BHU Institutional Repository :: Browsing by Author "Jain, P."

Browsing by Author "Jain, P."

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A Comparative Study of Some Treatment Modalities in Cutaneous Haemangiomas
(Georg Thieme Verlag, 2023) Jain, P.; Sinha, J.K.
Summary151 children with cutaneous haemangiomas were treated using different treatment modalities and the results were compared. Intralesional triamcinolone was found to be the safest and most effective in strawberry lesions. Cavernous lesions in our study responded best to 50% dextrose injections. A combined approach of oral prednisolone and triamcinolone injections was found to be very useful for mixed lesions. © 2023 Georg Thieme Verlag. All rights reserved.
Angiographic evaluation of fasciocutaneous flaps
(2006) Bhattacharya, V.; Goyal, Sunish; Jain, P.; Singh, Nepram S.
Extensive studies have been carried out to understand the vascular anatomy of fasciocutaneous flaps both in human cadavers and in experimental models. Seldom has angiographic study been undertaken in clinical cases. Before peroperative clinical angiography, microangiographic study was performed on rabbits to understand the vascular supply of the skin and deep fascia. Major vascular dominance could be seen in the deep fascia compared with the skin. Thereafter, peroperative angiography was carried out to visualize the vascular network of fasciocutaneous flaps. The study was conducted in 10 patients who required antegrade fasciocutaneous flap for exposed upper two thirds of the tibia. It showed longitudinally oriented rich vascular network in the flap. This study provided peroperative objective assessment of the nature of vascularity and an explanation for the viability of fasciocutaneous flaps of nonconventional dimensions. The procedure did not have any detrimental effect on the physiology of the flap.
Chronic lower limb wounds evoke systemic response of the lymphatic (immune) system
(2012) Olszewski, W.L.; Jain, P.; Zaleska, M.; Stelmach, E.; Swoboda, E.
Wound healing should not be considered as a process limited only to the damaged tissues. It is always accompanied by an intensive local immune response and in advanced stages, the systemic lymphatic (immune) structure. In this review we present evidence from our own studies as well as pertinent literature on the role of skin and subcutaneous tissue lymphatics at the wound site and of transport of antigens along with collecting afferent lymphatics to the lymph nodes. We also speculate the role of lymph nodes in raising cohorts of bacterial and own tissue antigen-specific lymphocytes and their participation in healing and not infrequently evoking uncontrolled chronic immune reaction causing a delay of healing. It is also speculated as to why there is a rapid response of lymph node cells to microbial antigens and tolerance to damaged-tissue-derived antigens occurs.
Melanotic neuroectodermal tumour of infancy: A rare maxillary alveolar tumour
(Springer Verlag, 2003) Jain, P.; Saxena, S.; Aryya, N.C.
Melanotic neuroectodermal tumour of infancy is a rare, but usually benign, pigmented neoplasm occurring in the first few months of life. The most frequent site is anterior maxillary alveolar ridge. It should be differentiated from other head and neck neoplasms of infants. Computed tomography and fine-needle aspiration cytology are the choice of investigations while two-cell population of neuroblasts and melanocytes on histology confirms the diagnosis. Treatment is early conservative surgical excision with long-term follow-up to detect recurrence and malignant transformation. A classical case of a 7-month-old infant is described with a brief review of the literature.
Novel classification of posttraumatic ear deformities and its surgical management
(Georg Thieme Verlag, 2020) Kumar, Umesh; Jain, P.
Background Classification of posttraumatic ear deformities and its reconstruction is an uphill task for a reconstructive surgeon as they present in various combinations. In our study, we have described ear deformity as per a new classification and reconstructed the ear accordingly. Method Posttraumatic ear deformity was described under the following four headings: (a) zone of defect, (b) size of defect, (c) missing components, and (d) condition of surrounding skin. Twenty-six posttraumatic ear deformities were operated using postauricular skin flap (14), temporoparietal fascial (TPF) flaps (8), preauricular skin flap (1), intralesional excision (2), and primary closure with chondrocutaneous advancement in one patient. Costal cartilage was used for reconstruction of framework wherever required. Framework elevation was done 4 to 6 months postoperatively. Results Posttraumatic ear deformity was more common in males. Bite injury and road traffic accidents were the common causes. Zones I, II and III were most frequently involved. Four patients complained about size, contour, and projection of reconstructed ear. Three patients were not satisfied by the appearance of junction between reconstructed and residual ear. Four patients in whom the reconstruction was done with TPF, costal cartilage, and thin (SSG) split skin grafts complained of hyperpigmentation of reconstructed ear. Conclusion Classification of posttraumatic ear deformity and its reconstruction is a surgical challenge. Unscarred postauricular skin and TPF flaps are the workhorse flaps for reconstruction of acquired ear deformities. Our classification helps in describing the defect, documenting it, planning reconstruction, and aiding in assessing postoperative outcomes. © 2020 Georg Thieme Verlag. All rights reserved.
Preparation of autologous platelet-rich fibrin glue, an effective tissue adhesive in the haematology laboratory
(2004) Shukla, Jyoti; Jain, P.
[No abstract available]
Reconstructing and resurfacing open neglected Achilles tendon injury by distal posterior tibial artery perforator based adipofascial flap
(2004) Mohanty, Ara; Jain, P.
Surgical management of open neglected Achilles tendon injury and damaged overlying skin is very demanding. Here, we report a case of 50 year-old man who sustained an injury to the left Achilles tendon causing complete disruption of the tendon with an open wound. The patient came to us after 3 months and was managed by tendon debridement, reconstruction by the Bosworth method, and resurfacing with a distal posterior tibial artery perforator based turn-over adipofascial flap covered with a split thickness skin graft. There was min-imal skin graft loss which healed by itself. A 9 month follow up of the reconstructed tendon showed a good functional result and a normal range of dorsi and plantar flexion of the foot. This technique provides an easy and quick solution to resurface the tendoachilles with minimal donor site morbidity. © Springer-Verlag 2004.
Reconstruction of the eyelid and periocular region: Our experience
(Regional Institute of Medical Sciences, 2018) Kumar, Umesh; Jain, P.
Aim: To use periocular flaps for defects involving different zones of eyelid. Materials and Methods: This study was conducted from 2015 to 2017. Twenty four patients with lid defects were managed by cheek rotation and advancement flap(8), Limberg flap(5), forehead flap(5), Mustarde’s lid switch flap (3), primary closure(1), SSG(2). Thirteen of our patients suffered from carcinoma, BCC(9) and SCC(4), patients with benign lesions had congenital melanocytic nevi(3), vascular malformation(2), congenital coloboma(3), cleft lower eyelid (1) and post traumatic eyelid defect(2). Eleven patients had full thickness defects and the rest had defect involving the anterior lamella. Result: Cheek rotation and advancement flap gave good results for anterior lamella, full thickness defect of zone II and adjoining periocular region with inconspicuous scar but ectropion in 2 cases. Limberg flap was used for defect involving lateral part of upper, lower eyelid and canthal region. In one case wound dehiscence occurred. Forehead flap gave linear scar. Mustarde’s lid switch flap was an ideal flap giving minimal donor site morbidity. All flaps survived with adequate coverage and uneventful healing. Conclusion: Periocular flaps are reliable, versatile flaps for reconstruction of all five zones of eyelid with good donor scar, colour and contour match. © 2018 Journal of Medical Society | Published by Wolters Kluwer-Medknow.
Study of epidemiology, clinical profile, visual outcome and prognostic factors of blunt ocular trauma in a teaching hospital
(IP Innovative Publication Pvt. Ltd., 2022) Maurya, Rajendra Prakash; Singh, Virendra Pratap; Gautam, Swati; Asha; Kumar, Anil; Mishra, C.P.; Jain, P.; Singh, Anjali; Singh, Shivangi; Ul Kadir, Syeed Mehbub; Pakdel, Farzad; Shukla, Ekagrata; Patel, Amit
Purpose: To describe the epidemiology, patterns of ocular trauma, clinical presentation, visual outcome and prognostic factors of blunt ocular trauma. Materials and Methods: A teaching hospital based prospective observational study was conducted over a period of 4 years from March 2012 to Feb 2016. 226 patients of all age group fulfilling the various inclusion and exclusion criteria were included in the study. All patients underwent detailed protocol based workup including a comprehensive ocular examination along with relevant radiological tests. Data regarding demographic profile, etiology, circumstances of the injury, traumatic agents, mode and mechanism of injury, extent and severity of injury, clinical features, management and visual outcome was analyzed and prognostic factors including ocular trauma score were evaluated. Results: Out of 402 total cases of ocular trauma, 226 caused by blunt objects were included in this study. 181 (80.1%) were male rest 45(19.9%) were female. The mean age was 42.6 ± 18.8 years. Blunt trauma was more prevalent in age group 16-25yrs (24.3%) followed by 26-35 years (23.9%). Majority (68.6%) of victims belonged to rural background. Most of the patients sustained trauma at road /street (30.5%) and home (27.9%). The most common cause of blunt trauma was road traffic accident (26.5%) followed by sports related injury (22.6%) and physical assault (21.7%). The most frequent traumatic agent was wooden object (26.0%) followed by stone / brick (25.2%) and metallic object (23.1%). Only 32.3% of patients had isolated ocular injuries, rest had associated polytrauma. 93.3% victims had unilateral ocular injury. Left eye (52.3%) was predominantly involved. Majority of injured eyes had more than 3 ocular structure involvement. Out of 241 injured eye 14.0% eyes had only globe injury while 61.4% eyes had simultaneous globe and adnexal injuries. 55.6% eyes had closed globe injury while 19.9% eyes had globe rupture. 20.7% eyes had purely posterior segment injury, while 23.2% eyes had both anterior and posterior segment injury. Most common clinical finding was corneal abrasion (45.6% eyes) followed by hyphema (44.0% eyes), traumatic mydriasis (35.7%), vitreous hemorrhage (33.2%) retinal detachment (20.3%), lens dislocation (22.8%) and traumatic cataract (17.4%). At the time of initial presentation 33.2% eyes had visual impairment and 35.7% eyes had blindness. 14.5% eyes with closed globe injury and 5.0% eyes with open globe injury had zone III injury. Ocular trauma score was in Category I in 14.9% injured eyes and in category II in 7.1% eyes. After 6 months 14.5% of the right eye and 24.2% of the left eye showed blinding outcome. Conclusion: Blunt trauma is the commonest mode of ocular injury. Young adult males are more vulnerable. Intraocular hemorrhage, zone III injury, posterior segment involvement and low ocular trauma score are poor prognostic factors. © 2022 Innovative Publication, All rights reserved.
Where do lymph and tissue fluid accumulate in lymphedema of the lower limbs caused by obliteration of lymphatic collectors?
(2009) Olszewski, Walderman L; Jain, P.; Ambujam, G.; Zaleska, M.; Cakala, M.
Obliteration of lymphatic collecting trunks of limbs by infective processes, trauma, oncologic surgery and irradiation bring about retention of lymph and tissue fluid in tissues. Knowledge as to where excess lymph is produced and accumulates as tissue fluid is indispensable for rational physical therapy. So far, this knowledge has been based on lymphoscintigraphic, ultrasonographic and MR images. None of these modalities provides distinct images of dilated lymphatics and fluid expanded tissue spaces in dermis, subcutis and muscles. Only anatomical dissection and histological processing of biopsy material can demonstrate the remnants of the lymphatic network and the sites of accumulation of mobile tissue fluid. We visualized and calculated the volume of the "tissue fluid and lymph" space in skin and subcutaneous tissue of foot, calf, and thigh in various stages of lymphedema, using special coloring techniques in specimens obtained during lymphatic microsurgical procedures or tissue debulking. When the collecting trunks were obliterated, lymph was present only in the subepidermal lymphatics, while mobile tissue fluid accumulated in the spontaneously formed spaces in the subcutaneous tissue, around small veins, and in the muscular fascia. Deformation of subcutaneous tissue by free fluid led to formation of interconnecting channels. In obstructive lymphedema caused by obliteration of collectors, lymph is present mainly in subepidermal lymphatics, and the bulk of stagnant tissue fluid accumulates in subcutis between fibrous septa and fat globules as well as above and underneath muscular fascia. These observations provide useful clues for designing pneumatic devices and rational manual lymphatic massage to move stagnant tissue fluid toward the non-swollen regions.

Browsing by Author "Jain, P."

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