Browsing by Author "Khanna, Soumya"
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Publication Approach to a Case of Ulcer of Extremity(Springer Nature, 2023) Khanna, Ajay K.; Khanna, SoumyaAn ulcer is a break in the skin or mucus membrane caused by the microscopic death of tissues. Ulcers can occur in any portion of the body, at any age, and in either gender. Ulcers can be either acute or persistent. Acute ulcers normally heal quickly, but chronic ulceration occurs when the ulcer lasts longer than 6 weeks and shows no signs of healing after three or more months. Ulcers are lesions that have a �full thickness depth�, and chronic ulcers heal slowly. Skin ulceration may be extremely painful and even fatal in severe cases. Chronic ulcers are frequently difficult to heal and may be related with a variety of psychological issues. It has a negative impact on one�s quality of life since it is connected with discomfort, swelling, and discharge that can be foul-smelling or bleeding. � The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.Publication Assessment of Quality of Life in venous ulcer(Edizioni Minerva Medica, 2021) Tiwary, Satyendra K.; Kumar, Manoj; Khanna, Soumya; Kumar, Puneet; Khanna, Ajay K.BACKGROUND: Typically, venous ulcers are recurrent in nature and with increased treatment cost leads to personal, social, mental and economic impact affecting Quality of Life (QoL). Generic tools are widely available in various languages have been frequently used to assess QoL. Among the various specific tools, Charing Cross Venous Leg Ulcer (CCVLU) Questionnaire showed high reliability, validity and responsiveness and shows good correlation with SF-36 in assessing HRQoL(Health related Quality of Life). METHODS: This study included 50 patients with venous ulcer and 56 limbs (six patients had bilateral ulcers). Quality of Life of venous ulcer patients was assessed by using SF-36 Questionnaire, The Charing Cross Venous Ulcer Questionnaire (CXVUQ) and Revised venous clinical severity score (VCSS), the changes in Quality of Life after treatment was compared to initial presentation in venous ulcer patients. RESULTS: After treatment, venous ulcer healed in all, except in 7 (12.5%) patients. Recurrence of venous ulcer was seen in 12 (21.43%) limbs. Quality of Life of patients prior to treatment and after the treatment by using SF-36 Questionnaire, Charing Cross Venous Ulcer Questionnaire, Revised Venous Clinical Severity Score showed that there was significant improvement in Quality of Life of patients after treatment with P value of <0.001. CONCLUSIONS: In our study, we found significant improvement in Quality of Life in patients of Venous ulcers after giving various modality of treatment which included Endovascular intervention and Four-layer dressing. � 2021 Edizioni Minerva Medica. All rights reserved.Publication Bacteriological Study of Varicose Vein Specimens(Springer, 2023) Khanna, Ajay K.; Katiyar, Awaneesh; Khanna, Soumya; Nath, Gopal; Kumar, Puneet; Tiwary, Satyendra K.Varicosity and chronic venous insufficiency (CVI) are thought to be due to reflux or pathologic retrograde flow caused by an incompetent venous valve leading to venous hypertension followed by reflux. A variety of factors have been postulated in association with varicose veins. Venous hypertension leading to reflux and varicosity may be associated with inflammation due to microbiological activity. This study was carried out with the objective that infection can be an etiological factor for varicose veins. A prospective study was carried out at a tertiary health care center from June 2014 to December 2020. A total of 100 patients with varicose veins (with 120 limb involvement) were recruited. Samples of normal leg veins were taken as control from 10 patients who were undergoing saphenous vein bypass grafting or amputated limb following road traffic accidents. We studied the primary varicose veins for microbiological etiology of the disease by culture studies of varicose veins and further confirmation by 16�s-rRNA PCR analysis. The sample of veins harvested during intervention was submitted for microbiological culture. Out of 42 cultures, Pseudomonas spp. in 6 cases (14.29%), Klebsiella spp. in 4 cases (9.52%), 2 cases (4.76%) each of Staphylococcus aureus and Proteus spp., and one case of Citrobacter on bacterial culture of truncal veins and on 16�s-rRNA PCR on DNA extracted from truncal varicose vein samples. Pseudomonas spp., Staphylococcus aureus, Klebsiella spp., Proteus spp., and Citrobacter spp. were detected in 10 cases (23.81%), 6 cases (14.29%), 5 cases (11.9%), 2 cases (4.76%), and 1 case (2.38%), respectively. In the ten specimens of normal vein, taken as control, 9 cases show no bacterial growth and 1 (10%) case shows a growth of micrococci. In consideration of the results of the present study, microbiological etiology of varicose veins is a distinct association which was confirmed in this study. � 2021, Association of Surgeons of India.Publication Correlation of various platelet indices and its association with susceptibility to develop DVT(Edizioni Minerva Medica, 2022) Tiwary, Satyendra; Das, Anand; Khanna, Soumya; Das, Debabrata; Kumar, Puneet; Khanna, AjayBACKGROUND: Venous thromboembolism (VTE) comprises DVT and PE, and either of them can be asymptomatic. The major disaster associated with deep vein thrombosis is when thrombus embolizes towards the heart and lungs where it lodges in the pulmonary arteries, known as pulmonary embolism. Deep venous thrombosis (DVT) is a serious disease not only because of the risk of developing pulmonary embolism (PE), but also of its risk for long-term sequelae. Several parameters may help in the identification of deep vein thrombosis (DVT). Several studies proposed that larger mean platelet volume (MPV) is an indicator of increased in-vivo platelet activation. Several studies have shown that increased platelet activity is associated with a greater risk of vascular events. Platelets play an important role in thrombus formation and the pathogenesis of atherosclerosis. METHODS: A total number of 33 cases and 33 controls were included in this study. We included all patients who were positive for acute deep vein thrombosis (DVT) as confirmed by Duplex scan. Patients on antiplatelet/anticoagulant therapy were excluded from the study. Clinical assessment of all patients, detailed history and physical examination was performed and recorded in proforma. Two mL of blood were collected in lavender top vials containing Di-potassium Ethylenediaminetetraacetic acid (K2EDTA) and analyzed in Beckmann Coulter fully automatic analyzer. RESULTS: Out of 33 patients, 16 patients were males and 17 were females. Majority of patients (16 out of 33, 48.4%) belong to middle age group (20-40 yrs). Receiver operating characteristic (ROC) curve analysis for platelet larger cell ratio (P-LCR) showed area under curve 0.701, P=0.005 (significant). Cut-off value was 38.25, sensitivity and specificity were both 60%. Patients were divided in two groups with PLCR<38.25% and P-LCR>38.25%. When compared, MPV was significantly low in P-LCR<38.25% and high in P-LCR>38.25% (9.2�0.9 fL vs. 10.3�1.2 fL; P=0.012). Rest correlations were insignificant. CONCLUSIONS: In conclusion, leukocytosis present in deep venous thrombosis (DVT) may be due to associated comorbidities. Moreover, combination of various platelet indices with D-dimer test can increase detection sensitivity of cases with deep venous thrombosis. � 2022 EDIZIONI MINERVA MEDICA.Publication Degradation of Xenobiotic Pollutants: An Environmentally Sustainable Approach(MDPI, 2022) Miglani, Rashi; Parveen, Nagma; Kumar, Ankit; Ansari, Mohd. Arif; Khanna, Soumya; Rawat, Gaurav; Panda, Amrita Kumari; Bisht, Satpal Singh; Upadhyay, Jyoti; Ansari, Mohd NazamThe ability of microorganisms to detoxify xenobiotic compounds allows them to thrive in a toxic environment using carbon, phosphorus, sulfur, and nitrogen from the available sources. Biotransformation is the most effective and useful metabolic process to degrade xenobiotic compounds. Microorganisms have an exceptional ability due to particular genes, enzymes, and degradative mechanisms. Microorganisms such as bacteria and fungi have unique properties that enable them to partially or completely metabolize the xenobiotic substances in various ecosystems.There are many cutting-edge approaches available to understand the molecular mechanism of degradative processes and pathways to decontaminate or change the core structure of xenobiotics in nature. These methods examine microorganisms, their metabolic machinery, novel proteins, and catabolic genes. This article addresses recent advances and current trends to characterize the catabolic genes, enzymes and the techniques involved in combating the threat of xenobiotic compounds using an eco-friendly approach. � 2022 by the authors.Publication Embryology of Vascular Malformation(Springer Singapore, 2021) Khanna, Soumya; Khanna, Ajay K.A thorough understanding of vascular system is a prerequisite for vascular specialists. The knowledge of venous development is often ignored despite the fact that all the mature and named vessels originate from their precursor i.e. embryonic vessels and any vascular anomalies is closely correlated with its development This chapter has tried to cover the development of arterial, venous and lymphatic system and its associated anomalies. � Springer Nature Singapore Pte Ltd. 2021.Publication Glut 1, S-100, and Nerve Bundle Study in Vascular Anomalies(Springer, 2023) Khanna, Ajay K.; Kumar, Akhilesh; Khanna, Soumya; Kar, Amrita; Kumar, Puneet; Tiwary, S.K.Vascular anomalies grouped into vascular tumors (hemangioma) (HI) and vascular malformation (VM) are benign vascular lesions that are difficult to distinguish from one another clinically and often confused with each other at histopathology. This confusing terminology leads to improper diagnosis, illogical treatment, and misdirected research. This study aimed to study GLUT 1, S-100, and nerve bundle to differentiate hemangioma and vascular malformation. Thirty two cases of vascular lesions (26 vascular malformations and 6 hemangiomas) were taken into the study. For histological evaluation and immunohistochemistry (IHC), samples of vascular lesions were collected in formalin. All the hematoxylin and eosin-stained slides were evaluated under light microscope for histology and nerve bundles. Immunohistochemical staining was performed by streptavidin�biotin method for GLUT 1 and S-100. GLUT 1 was positive in all 6 cases of hemangiomas (100%) and only in 1 case of vascular malformation. Nerve bundle was present in 24 cases of vascular malformation (92.3%) out of 26 cases but not in any cases of hemangioma and S-100 was found positive in all vascular malformation cases (100%) but not in hemangioma. So GLUT 1 expression, S-100, and presence of nerve bundle in vascular lesions can help to differentiate hemangioma and vascular malformation. � 2021, The Author(s).Publication Prothrombin Fragment 1 + 2 in Urine and Plasma and D-dimer in Patients with Clinically Suspected Venous Thromboembolism(Springer, 2023) Khanna, Ajay K.; Chander, Pramesh; Khanna, Soumya; Kumar, Sandeep; Tiwary, S.K.; Puneet; Yadav, SujitIn recent years, several biomarkers have been found to be associated with deep vein thrombosis (DVT). D-dimer is a degradation product of a cross-linked fibrin blood clot and has a negative value in the diagnosis of DVT. Prothrombin fragment 1 + 2 (p F1 + 2) is a non-thrombotic polypeptide that is cleaved from Prothrombin during its conversion to thrombin. The study aims to evaluate the D-dimer and to evaluate Prothrombin fragment 1 + 2 in urine and plasma in clinically suspected DVT patients. This study comprised of 30 patients who are clinically suspected cases of deep vein thrombosis, carried out from July 2018 to May 2020 in the Department of General Surgery, IMS BHU, Varanasi. In our study, D-dimer and plasma F1 + 2 both showed comparable results in patients of venous thromboembolism (VTE). Proximal DVT tended to have higher levels of D-dimer and had significantly higher levels of F1 + 2 than patients with distal DVT. In our study, a positive correlation was found between D-dimer and plasma F1 + 2 (r = 0.588 and p-value 0.006) in DVT-positive patients. There is no correlation between plasma D-dimer and urine F1 + 2 (r = ? 0.0.07 and p-value 0.769) In conclusion, Prothrombin F1 + 2 is an important marker raised in patients with DVT. � 2022, Association of Surgeons of India.Publication Reply of letter to the editor: Assessment and grading of pigmentation in chronic venous insufficiency in Phlebology 2020(SAGE Publications Ltd, 2023) Tiwary, Satyendra K; Kumar, Praveen KG; Dhameeja, Neeraj; Kumar, Puneet; Khanna, Ajay K; Khanna, Soumya[No abstract available]
