132 results on '"Mahajan JK"'
Search Results
2. Endoscopic Management of Vesicoureteral Reflux and Long-term Follow-up
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Rao, Kln, Menon, Prema, Samujh, R, Mahajan, Jk, Bawa, M, Malik, Ma, and Mittal, Br
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- 2018
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3. Photographic Journey of Cushing Syndrome
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Yadav, Jaivinder, primary, Gupta, Saniya, additional, Kumar, Rakesh, additional, Mahajan, JK, additional, Sodhi, Kushaljit, additional, Thirunavukkarasu, Balamurugan, additional, and Dayal, Devi, additional
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- 2020
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4. Consensus on the management of posterior urethral valves from antenatal period to puberty
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Sharma, Shilpa, primary, Joshi, Manoj, additional, Gupta, DevendraK, additional, Abraham, Mohan, additional, Mathur, Praveen, additional, Mahajan, JK, additional, Gangopadhyay, AN, additional, Rattan, SimmiK, additional, Vora, Ravindra, additional, Prasad, GRaghavendra, additional, Bhattacharya, NC, additional, Samuj, Ram, additional, N. Rao, KL, additional, and Basu, AK, additional
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- 2019
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5. Penile hair tourniquet syndrome: A case report and review of literature
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Sekhon, Virender, primary, J Peters, Nitin, additional, and Mahajan, JK, additional
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- 2017
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6. Covered exstrophy with anorectal malformation and vaginal duplication
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Mahajan, JK, primary, Bawa, Monika, additional, Rao, K. L. N., additional, and Singh, JitendraK, additional
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- 2011
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7. Esophageal atresia and tracheoesophageal fistula: Effect of pleural cover on anastomotic dehiscence
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Mahajan, JK, primary, Bawa, Monika, additional, Rao, KL.N, additional, and Gupta, Money, additional
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- 2011
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8. Transanal Swenson′s operation for Recto-sigmoid Hirschsprung′s disease
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Mahajan, JK, primary, Bawa, Monika, additional, Rathod, KirtiK, additional, and Narasimhan, KL, additional
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- 2011
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9. Ectopic adrenocortical rest in the wall of the large intestine
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Bal, Amanjit, primary, Adhya, AmitKumar, additional, and Mahajan, JK, additional
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- 2009
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10. Segmental dilatation of colon associated with anorectal malformation
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Mahajan, JK, primary, Mohanan, A, additional, and Rao, KLN, additional
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- 2007
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11. Benign retroperitoneal mesenchymoma of childhood
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Mahajan, JK, primary, Ojha, Sunita, additional, Vaiphei, Kim, additional, and Rao, KLN, additional
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- 2007
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12. Anterior urethral valves associated with hypospadias
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Mahajan, JK, primary, Ojha, Sunita, additional, and Rao, KLN, additional
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- 2007
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13. Anorectal malformations in children
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Bhargava, Pranshu, primary, Mahajan, JK, additional, and Kumar, Ajay, additional
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- 2006
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14. Gangrene of an occipital encephalocele.
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Sinha A, Ojha S, Mahajan JK, Sinha, Arvind, Ojha, Sunita, and Mahajan, J K
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- 2005
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15. Herniation of transverse colon into parietal wall after blunt trauma.
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Devendra K, Mahajan JK, and Rao KLN
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- 2002
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16. Partial Tubular Esophageal Duplication: An Uncommon Congenital Foregut Anomaly.
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Hegde SG, Thakur A, Bhatia A, Muhammad R, Mahajan JK, Sodhi KS, and Saxena AK
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- 2024
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17. Comparison of the Role of Anticholinergics and α-1 Adrenergic Blockers in Bladder Management in Posterior Urethral Valves: A Pilot Randomized Control Trial.
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Bade R, Mahajan JK, Kalavant A, Behera S, Singhai P, and Saxena A
- Abstract
Introduction: Posterior urethral valve (PUV) is a major cause of congenital bladder dysfunction, often persisting despite treatment. Emerging therapies, including anticholinergics and α-1 blockers, offer potential but lack clear guidelines. This study evaluates their effectiveness in improving bladder function after valve fulguration., Methods: Twenty PUV patients, aged ≥3 years, were randomized into anticholinergic (group A, n = 11) and α-1 adrenergic blocker (group B, n = 9) groups post-fulguration. Follow-up included clinical, radiological, and urodynamic assessments 6 months posttreatment initiation., Results: In group A, the mean maximum detrusor pressure (Pdet) decreased from 30.17 to 23.45 cm H2O (p = 0.033). Two patients normalized from high detrusor pressure (>40 cm H2O). In group B, 1 patient retained high detrusor pressure posttreatment. Group B improved in average urinary flow (Q avg) and maximum flow rate (Q max), with all patients having initially low Q avg (<10 mL/s). Two group B patients showed improved average flow rates posttreatment (p = 0.016); three in group A showed improvement but were not statistically significant (p = 0.197). Q max/flow time ratio was abnormal in all group B patients pretreatment. Two of the nine improved posttreatment, while only one in group A did., Conclusions: Anticholinergic medications positively impact cystometric parameters and are effective for detrusor instability and low compliance bladder. α-Adrenergic blockers influence uroflow parameters and can help treat bladder outflow obstruction. Consideration for a larger study with extended follow-up is warranted., (© 2024 S. Karger AG, Basel.)
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- 2024
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18. Perineal Bowel - An Isolated Anomaly or Part of a Complex?
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Janapareddy KK, Mahajan JK, Solanki S, and Sekar A
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- Humans, Infant, Newborn, Perineum surgery
- Published
- 2024
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19. Repair of Type C Tracheo-esophageal Fistula/Esophageal Atresia With or Without Trans Anastomotic Tube: A Pilot Randomized Controlled Trial.
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Bade R, Peters NJ, Dogra S, Malik MA, Mahajan JK, Yaddanapudi S, Solanki S, Bawa M, and Samujh R
- Abstract
Background: The use of trans anastomotic feeding tube (TAFT) during the repair of Esophageal atresia/Tracheo-esophageal fistula (EA/TEF) aims to enhance outcomes by enabling early feeding, reducing the requirement for parenteral nutrition, and reducing complications such as anastomotic leak by stenting the anastomosis. However, TAFT's benefits and drawbacks are debated due to conflicting reports. Thus, we conducted a prospective pilot randomized control trial to elucidate the impact of TAFT on postoperative outcomes and the potential benefits of avoidance of TAFT., Methods: We performed a single-center randomized controlled trial in 53 neonates diagnosed with Type C EA/TEF who were operated on from January 2022 to June 2023. The patients were randomized into TAFT (n = 30) and non-TAFT (n = 23) groups. The patients were followed up for a minimum of 6 months following discharge. The primary objective of the study was to compare the rate of anastomotic leaks following primary repair of EA/TEF in both groups. Secondary objectives included early postoperative outcomes such as the occurrence of anastomotic stricture, time taken to initiate feeding, the time required to reach full feeding, the incidence of brief resolved unexplained events (BRUE) or acute life-threatening events (ALTE), the incidence of gastroesophageal reflux (GER), somatic growth, and all-cause mortality within 30 days post-surgery., Result: The study demonstrated that TAFT placement was associated with a higher incidence of anastomotic leaks (20 % vs 0, p = 0.03). However, there was no difference in the 30-day mortality between both groups. Although the rate of anastomotic strictures and GER was higher in the TAFT group (54.5 % vs 27.8 %, p = 0.08 and 25 % vs 57.1 %, p = 0.076), it did not reach statistical significance. Avoiding TAFT resulted in earlier initiation of enteral feeding (18 vs 22 days, p = 0.002), shorter time to achieve full feeds (15 vs 21 days, p = 0.03), reduced duration of TPN (3 vs 10 days; p = 0.001), improved weight gain at the 2-week follow-up (27.5 vs. 24.4 g/kg/day, p-value = 0.037) and lesser incidence of ALTE/BRUE (11.1 % vs 48 %, p = 0.01) at 6 months., Conclusion: While previous research has covered TAFT's impact on complications such as anastomotic leak, stricture, use of TPN and enteral feed, prospective randomized studies remain limited, and the impact on GER, somatic growth, and occurrence of ALTE/BRUE is still unexplored. This study evaluated the short-term outcomes of EA/TEF in a resource-challenged setting, shedding light on the potential benefits of repair without TAFT such as reduction in the rate of anastomotic leak, earlier feeding, reduced GER, better somatic growth and reduced incidence of ALTE/BRUE., Level of Evidence: Level II (Treatment study/Randomized controlled trial)., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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20. The Role of Liquid Biopsy in Neuroblastoma: A Scoping Review.
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Singh J, Peters NJ, Avti P, Trehan A, Mahajan JK, Menon P, Bansal D, and Kanojia RP
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Background: Neuroblastoma (NBL), is the most common, non-CNS solid tumor of childhood. This disease presents with unique biological and clinical challenges necessitating accurate diagnosis, prognosis assessment, treatment, and vigilant monitoring. Liquid biopsy is an upcoming, innovative, and non-invasive diagnostic modality. It has the potential to detect tumors and perform therapeutic monitoring through the analysis of circulating biomarkers in blood, urine, saliva, and other bodily fluids., Methodology: This scoping review offers an in-depth exploration, of the current landscape of liquid biopsy-based biomarkers in NBL. The review looks at the clinical implications, prevalent challenges, and future outlook of their clinical applications in NBL. The scoping review adhered to the guidelines of the PRISMA extension for scoping reviews, known as PRISMA-ScR, as the skeletal framework. The review involved comprehensive searches for liquid biopsy-based biomarkers in NBL across multiple databases, including PUBMED, EMBASE, SCOPUS, and WEB of Science, without restrictions., Results: The scoping review process uncovered a significant body of literature (n = 201) that underwent meticulous scrutiny, ultimately leading to the final selection of studies (n = 15). The liquid biopsy biomarkers included circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), exosomes, and other entities in bodily fluids. Their evaluation focused on associations with clinical outcomes such as overall survival, event-free survival, and risk stratification in NBL., Conclusion: Our findings highlight the potential of liquid biopsy biomarkers to revolutionize NBL diagnosis and therapeutic monitoring. This rapidly evolving frontier in pediatric oncology suggests significant advancements in precision medicine for the management of NBL., Competing Interests: Conflict of interest All authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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21. Surgically Correctable Central Cyanosis: Congenital Extrahepatic Portosystemic Shunt in a Child.
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Bade R, Peters NJ, Mathew JL, Sen IM, and Mahajan JK
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Congenital extrahepatic portosystemic shunts (CEPS) are rare anomalies connecting the portal system to the inferior vena cava. This report discusses a 10-year-old boy with Type II c CEPS, presenting cyanosis and dyspnea. Surgical ligation resulted in significant improvement in symptoms. Early identification and intervention are crucial, necessitating a protocolized approach., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)
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- 2024
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22. Tracheal bronchus with segmental bronchial atresia and a supra superior bronchus: An uncommon myriad of airway anomalies.
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Hegde SG, Shandil A, Bhatia A, Sodhi KS, Mahajan JK, and Saxena AK
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- Humans, Abnormalities, Multiple diagnostic imaging, Bronchoscopy, Tomography, X-Ray Computed, Bronchi abnormalities, Bronchi diagnostic imaging, Trachea abnormalities, Trachea diagnostic imaging
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- 2024
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23. Randomized controlled trial to evaluate the rate of successful neonatal endotracheal intubation performed with a stylet versus without a stylet.
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Solanki S, Dogra S, Gupta PK, Peters NJ, Malik MA, and Mahajan JK
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- Infant, Newborn, Infant, Humans, Respiration, Artificial, Tertiary Care Centers, Equipment Design, Intubation, Intratracheal methods, Intensive Care Units, Neonatal
- Abstract
Introduction: Neonates in intensive care units often require endotracheal intubation and mechanical ventilation. During this intubation procedure, a stylet is frequently used along with an endotracheal tube. Despite the widespread use of a stylet, it is still not known whether its use increases the intubation success rate. This study examined the association between stylet use and the intubation success rate in surgical neonates., Methodology: This single-center study was conducted between December 2021 and December 2022 in the Neonatal surgical intensive care unit of a tertiary care center in Northern India. Infants were randomized to have the endotracheal intubation procedure performed using either an endotracheal tube alone or with a stylet. The primary outcome of the study was to assess the successful first-attempt neonatal endotracheal intubation rate with and without using a stylet. Apart from the rate of successful intubation, the duration of the intubation and complications during the intubation procedures as measured by bradycardia, desaturation episodes, and local trauma were also recorded. Both groups were thus compared on above mentioned outcomes., Results: The total number of neonates enrolled were 200, and the overall success rate (81% in the stylet group vs. 73% in the non-stylet group) was not statistically significant. Intubation time was however less, when stylet was used (16.2 ± 4.3 vs. 17.5 ± 5.0 s, p = .046). When the endotracheal tube size was 3 or less, the success rate was substantially higher in the stylet group (80%) than the non-stylet group (63%), p = .03. No statistical difference was recorded for bleeding and local trauma, though the esophageal intubation rate was higher when intubation was attempted without the stylet., Conclusion: Endotracheal intubation using a stylet did not significantly improve the success rate of the procedure, however, intubation time significantly varied between groups and in different conditions. The rigidity and curvature provided by the stylet may facilitate the process of intubation when smaller caliber endotracheal tubes are used., (© 2024 John Wiley & Sons Ltd.)
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- 2024
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24. Penile Epithelioid Hemangioendothelioma in a Child.
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Singhai P, Peters NJ, Sekar A, Bora GS, Gorsi U, and Mahajan JK
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An 8-year-old boy initially thought to have a penile arteriovenous malformation was later diagnosed with a rare vascular sarcoma, epithelioid hemangioendothelioma (EHE). Despite challenges in diagnosis, he underwent supraselective angioembolization and partial penectomy for oncological clearance. EHE, a low-grade malignancy, requires prompt identification and treatment due to potential systemic involvement., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)
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- 2024
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25. Extragonadal Germ Cell Tumor with Hepatic Infiltration in a Child: Aberrant Somatostatin Receptors and the Diagnostic Conundrum.
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Peters NJ, Behera S, Gupta P, Jain R, Singh H, Madan R, and Mahajan JK
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Extragonadal germ cell tumors (GCTs) are challenging to diagnose. We present a case of suprarenal GCT, with hepatic infiltration where differential diagnosis included neuroblastoma and hepatoblastoma. The positive positron emission tomography scan further obfuscated the situation. The diagnosis was clinched by fine-needle aspiration cytology and cell block immunohistochemistry., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)
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- 2024
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26. Tubularized incised plate urethroplasty and grafted tubularized incised plate urethroplasty: systematic review, meta-analysis and trial sequential analysis.
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Borkar N, Tiwari C, Nair A, Mohanty D, Sinha CK, and Mahajan JK
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Background: Hypospadias is one of the most common genital birth defects. There are around 300 various techniques available for the repair of hypospadias. This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty (TIP) and Grafted TIP (GTIP) repair in children undergoing primary hypospadias repair., Methods: This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and we framed our research question using the population, intervention, control and outcomes format. We conducted comprehensive electronic searches across various databases, employing a Boolean search strategy with predefined search terms. Only randomized controlled trials (RCTs) were included for quantitative analysis., Results: Totally, 10 RCTs met our inclusion criteria for quantitative analysis. The results indicated that urethrocutaneous fistula, glans dehiscence, and stricture rates were comparable between the two groups. The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk (RR) of 0.32 (95% confidence interval (CI) 0.15 to 0.67)., Conclusion: The coucomes UCF, glans dehiscence, and stricture rates were comparable between the two groups. Notably, the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group. In terms of operative time, our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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- 2024
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27. Differential invasiveness & expression of antimicrobial peptides in Shigella serotypes.
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Narayan C, Kant V, Mahajan JK, Mohan B, and Taneja N
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- Animals, Child, Humans, Serogroup, Antimicrobial Peptides, Shigella flexneri genetics, Shigella genetics, Dysentery, Bacillary genetics, Dysentery, Bacillary microbiology
- Abstract
Background & Objectives: The study of Shigella pathogenesis at present is severely hampered by the lack of a relevant animal model that replicates human bacillary dysentery. Different Shigella serogroups cause varying severity of clinical illness. Ex vivo colonization of Shigella flexneri, S. dysenteriae and S. sonnei were characterized in human paediatric colonic pinch biopsies in the in vitro organ culture (IVOC) model to study the invasiveness of Shigella by gentamicin protection assay (GPA). Furthermore, the expression of antimicrobial peptides (AMPs) in response to different serotypes of Shigella was also studied in IVOC model., Methods: IVOC explants were inoculated with 10
9 colony forming units of different serotypes of Shigella and recovery of bacteria studied. Histopathological analysis was carried out to study inflammatory immune responses. GPA was done to elucidate the invasiveness of different serotypes of Shigella. Secretions of AMPs were measured by enzyme-linked immunosorbent assay (ELISA). Western blotting was performed to check the expression of AMPs and nuclear factor kappa B in IVOC explants., Results: After 24 h post-infection, the colon biopsies showed intense inflammatory reaction. In both IVOC and GPA, S. dysenteriae 1 was the most invasive as compared to S. flexneri and S. sonnei. S. sonnei was the least invasive. ELISA demonstrated that S. sonnei dampened the HBD (human β-defensin)-2 responses whereas there was augmentation by S. dysenteriae and there was a modest but non-significant increase by S. flexneri. A modest increase in HBD-3 by S. sonnei and S. flexneri was observed but was not found to be significant. However, western blotting data showed upregulation of all AMPs by all serotypes. Western blotting is more sensitive than ELISA., Interpretation & Conclusions: In the present study, differences in invasiveness and AMP production induced by different serotypes of Shigella were found. Human intestinal IVOC represents a model system to investigate early interaction between pathogenic bacteria and the human gut.- Published
- 2023
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28. Colonic Atresia Associated with Biliary Atresia.
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Solanki S, Mahajan JK, Singhai P, and Mitra S
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Colonic atresia (CA) is an uncommon type of intestinal atresia commonly associated with other anomalies, while biliary atresia (BA) is also rare but usually an isolated anomaly. The pathogenesis for either of the anomalies is unclear. The co-occurrence of both pathologies has not been mentioned in the literature. We here discuss the management of CA with BA and the review of pertinent literature., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Indian Association of Pediatric Surgeons.)
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- 2023
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29. A Randomized Control Trial to Evaluate the Effect of Local Instillation of Mitomycin-C at the Porta after Kasai Portoenterostomy in Patients of Biliary Atresia.
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Solanki S, Kanojia RP, Gupta PK, Singhai P, Lal SB, and Mahajan JK
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Background: Kasai portoenterostomy (KPE) is the initial treatment for biliary atresia (BA). Even after initial jaundice clearance, a significant number of children presented with the reappearance of symptoms due to ongoing fibrosis involving porta and intrahepatic ducts. Mitomycin-C (MMC) is an antifibrotic agent, and the study hypothesized that local application of MMC at porta can decrease fibrosis, which can improve jaundice clearance and lead to better native liver survival (NLS)., Materials and Methods: This prospective randomized control trial included children with BA, who were allocated to groups A or B. The patients in both groups underwent standard KPE; in addition, a 5 French infant feeding tube (IFT) was placed near the porta through the Roux limb in Group B children. During the postoperative period, MMC was locally instilled over the porta in Group B children through IFT. Postoperative jaundice clearance and NLS were assessed and compared., Results: A total of 27 children were enrolled in the study, 16 in Group A and 11 in Group B. Both groups were comparable preoperatively. Although the NLS was not statistically significant in Group B, the survival was quite higher, that was 91%, 81%, and 73% at 6 months, 1 year, and 2 years, respectively, compared to 63%, 50%, and 38% in Group A., Conclusion: Children in Group B clinically showed an early jaundice clearance and a better trend of serial bilirubin levels as well as longer NLS than Group A, but it was not statistically significant. The procedure was technically easy, and no complication was encountered related to surgical technique or MMC instillation., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Indian Association of Pediatric Surgeons.)
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- 2023
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30. Factors affecting stress levels in parents of surgical neonates: A prospective observational study.
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Peters NJ, Kaur K, Dogra S, Kaur R, Malik MA, Solanki S, Bawa M, Menon P, Kanojia RP, Mahajan JK, and Samujh R
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- Infant, Newborn, Humans, Infant, Young Adult, Adult, Prospective Studies, Family, Anxiety, Parents, Intensive Care Units, Neonatal
- Abstract
Background: There is a paucity of research focusing on the stress levels in parents of newborns undergoing surgery. Resource challenged systems have to deal with overcrowding, a shortage of workforce along with demographic and socioeconomic issues like delayed presentations and out of pocket expenses. The primary objective of this study was to understand the factors associated with stress in the parents of these congenitally malformed neonates., Methodology: This was a prospective cohort study, which was conducted in a neonatal surgical ICU of a tertiary care teaching hospital. Factors affecting stress levels in parents of surgical neonates were studied in 100 participants. A multi-dimensional questionnaire - The PSS: NICU score was utilized in the study. The parents were interviewed on Day 3-5 after surgery., Result: 59% of the respondents were fathers. The majority of the parents were in the age bracket of 24 to 35 years. The mean scores for the subscales sights and sounds, looks and behavior and alteration in the parental role were 3.24±0.8, 3.52±0.63, 3.55±0.8 and 2.8 ± 0.9 respectively. The highest level of stress was found in the domains of alteration of parental role and infant appearance and behavior. Comparisons showed significantly higher maternal scores in all the domains. Overall stress scores were highest for abdominal wall defects., Conclusion: Parents of neonates undergoing surgery suffer from significant stress levels and appropriate counseling targeted towards specific stressors is required to allay this important parental issue., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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31. Congenital Malignant Rhabdoid Tumor of Neck.
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Reddy M, Mahajan JK, Dhanasekaran V, and Dogra S
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Malignant rhabdoid tumors (MRT) are uncommon, highly aggressive tumors arising usually from the central nervous system and kidneys. Nonrenal and noncentral nervous systems MRT are rare in neonates. To the best of our knowledge, only five cases of congenital MRT of neck have been described till date. We present a rare case of congenital MRT of the neck in a neonate along with review of literature., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Indian Association of Pediatric Surgeons.)
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- 2022
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32. Pediatric perianal rhabdomyosarcoma: Multimodal therapy for tumor control.
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Behera S, Mahajan JK, and Bansal D
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- Child, Combined Modality Therapy, Humans, Neoplasms, Rhabdomyosarcoma pathology, Rhabdomyosarcoma therapy, Rhabdomyosarcoma, Embryonal
- Published
- 2022
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33. Transcutaneous Electrical Nerve Stimulation in Management of Neurogenic bladder Secondary to Spina Bifida.
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Pattanshetti S, Mahajan JK, Saxena S, and Saxena A
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Aims: To assess the role of transcutaneous electrical nerve stimulation (TENS), alone or in combination with anticholinergic drugs in the management of neurogenic bladder (NB) in spina bifida (SB)., Materials and Methods: All the consecutive patients, visiting outpatient clinic between July 2017 and December 2018, who were toilet trained and at least 1 year post-SB surgery with clinical and/or urodynamic evidence of NB, were included in the study. Out of 65 patients, 40 fulfilled the inclusion criteria and were randomised into: group A (ten patients, placebo TENS with anticholinergic agents), Group B (14 patients, TENS therapy with placebo medications) and Group C (16 patients, TENS therapy with anticholinergic medications). All the patients maintained a voiding diary and underwent assessment before and after the intervention. The study was approved by the Institutional Ethics Committee., Results: The presenting symptoms were urinary incontinence (100%), increased frequency (45%), straining during micturition (22.5%), urgency (22.5%), and hesitancy (30%). The demographic parameters were comparable in all the groups. After group specific intervention, the wet episodes/day significantly improved in Group C ( P = 0.001). Similarly, the mean wet days/week also improved significantly in Group C (6.5-4.37 days/week, P = 0.01). Out of 40 patients, 29 had abnormal findings on ultrasonography before the start of the therapy. Following intervention, only two patients in Group C showed normalization of findings. On Urodynamic studies, detrusor pressure (Pdet max) decreased in all the groups; however, the patients in Group C, showed the maximum reduction (56.6 ± 11-30 ± 6.7 cm H
2 O). Similarly compliance (9.4 to 14.5 cm H2 O, P = 0.02) and bladder capacity (68%-88% of EBC, P = 0.001) also improved significantly in Group C as compared to other 2 groups Overall, nine patients (Group A, B, and C = 1, 3, and five patients, respectively) showed detrusor instability, while post therapy, only one patient (Group B) had unstable bladder. Maximum decrease in postvoid residue (mean) was also observed in Group C (77-41 ml, P = 0.01)., Conclusions: The application of TENS in NB secondary to SB is effective and its application led to improvement in symptoms, decrease in the wet episodes/day, maximum detrusor pressure, instability, bladder compliance, and capacity. TENS therapy in combination with anticholinergic agents had a better outcome as compared to monotherapy with either of the two modalities., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Indian Association of Pediatric Surgeons.)- Published
- 2022
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34. Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate.
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Kumar V, Rattan V, Rai S, Singh SP, and Mahajan JK
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- Animals, Bone Matrix transplantation, Bone Transplantation methods, Cancellous Bone diagnostic imaging, Cattle, Double-Blind Method, Humans, Ilium transplantation, Prospective Studies, Alveolar Bone Grafting methods, Cleft Lip diagnostic imaging, Cleft Lip surgery, Cleft Palate diagnostic imaging, Cleft Palate surgery
- Abstract
Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes., Design: Prospective, randomized, parallel groups, double-blind, controlled trial., Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh., Participants: Twenty patients with UCLP., Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months., Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting., Results: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I., Conclusions: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.
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- 2022
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35. Spontaneous Gallbladder Perforation in a Child With Anomalous Pancreaticobiliary Junction.
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Gauba R, Sodhi KS, Bhatia A, Mahajan JK, Malik MA, and Saxena AK
- Subjects
- Child, Humans, Pancreatic Ducts abnormalities, Pancreatic Ducts diagnostic imaging, Abdominal Injuries, Gallbladder Diseases complications, Gallbladder Diseases diagnostic imaging
- Abstract
Competing Interests: The authors declare no conflict of interest.
- Published
- 2022
- Full Text
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36. Differential dendritic immune cell responses to infection with various serotypes of Shigella.
- Author
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Narayan C, Kant V, Mahajan JK, Mohan B, and Taneja N
- Subjects
- Cytokines, Humans, Immunity, Interleukin-23, Interleukin-6, Interleukin-8, Leukocytes, Mononuclear metabolism, Serogroup, Tumor Necrosis Factor-alpha, Interleukin-17, Shigella
- Abstract
Purpose: Dendritic cells (DC) are key regulators of immune response with the ability to affect both the innate and adaptive immune responses and are abundant in the gut mucosa. The severity of shigellosis varies with the serotype involved with S. dysenteriae producing the severest infections with complications and S. sonnei being at the other end of spectrum usually causing mild self-limiting diarrhea. While Shigella are known to induce the apoptosis of mature DCs, there is no information on cytokine milieu of DCs incubated with different serotypes of Shigella., Methods: Monocyte derived dendritic cells (MoDCs) were developed from healthy human PBMC after 8 days of culture. DCs were infected with different Shigella serotypes. After 24 h post infection, relative expression of cytokines IL-1β, IL-6, IL-8, TNF-α, IL-12p70, IL-17, IL-22 and IL-23 was studied by Real Time PCR and cytometric bead arrays (CBA)., Results: We found that different serotypes of Shigella significantly stimulated production of IL-1β, IL-6, IL-8, IL-12, IL-23, INF-γ and TNF-α compared to uninfected DCs and there were significant differences among these serotypes. At transcriptional level, highest levels of expression of IL-1β, IL-6, IL-8, TNF-α, IFN-γ, IL-17, IL-22 and IL-23 were observed in S. dysenteriae infected DCs. Significant serotypic differences were noted between S. dysenteriae & S. flexneri and between S. dysenteriae &S. sonnei., Conclusions: DCs are critical sentinel cells that relay microbial presence either directly or indirectly to naive T cells. In this study we found that S. dysenteriae caused maximum expression of pro-inflammatory cytokines. Similarly, S. dysenteriae also caused highest expression of IL-17A and IL-22A. It was the only serotype, which increased IL-23. These findings could explain more severity of SD as compared to SF and SS., (Copyright © 2022 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
37. Neonatal Cushing Syndrome.
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Srinivasan S, Mahajan JK, Dayal D, Kumar R, Thirunavukkarasu B, and Yadav J
- Subjects
- Humans, Hydrocortisone, Infant, Newborn, Cushing Syndrome diagnosis
- Published
- 2021
- Full Text
- View/download PDF
38. Bladder Exstrophy with Anovestibular Fistula: A Rare Presentation.
- Author
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Yhoshu E and Mahajan JK
- Abstract
Competing Interests: There are no conflicts of interest.
- Published
- 2020
- Full Text
- View/download PDF
39. Giant Phyllodes Tumor in Ectopic Breast Tissue.
- Author
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Singh UB, Mahajan JK, and Vaiphei K
- Abstract
Breast masses are uncommon in children and adolescents. Ectopic breast tissue is further uncommon and may be present in locations such as the face, back, and thigh. A 12-year-old female child presented with a hard, nonmobile lump in the right breast. On exploration by submammary incision, the lump was found to be below the pectoralis major muscle and had no communication with the overlying orthotopic breast tissue. Histopathological examination revealed a well-encapsulated biphasic lesion, with features characteristic of a phyllodes tumor. We report a hitherto unreported case of aberrant breast tissue lying under the pectoralis muscle and containing phyllodes tumor., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Indian Association of Pediatric Surgeons.)
- Published
- 2020
- Full Text
- View/download PDF
40. Pediatric Trauma: Management and Lessons Learned.
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Hegde S, Bawa M, Kanojia RP, Mahajan JK, Menon P, Samujh R, and Rao KLN
- Abstract
Aim: The aim is to prospectively study 125 trauma patients admitted in the pediatric surgery ward in our institute., Materials and Methods: Pediatric patients admitted in the ward after initial resuscitation in the triage room were included. Isolated neurosurgical and orthopedic injuries were excluded. X-ray cervical spine, hip, and chest and a focused assessment with sonography in trauma ultrasound were done for all patients. Computed tomography of the abdomen or chest was done where relevant. Injury profile and surgical intervention when needed were analyzed., Results: Road traffic accidents and fall from height caused 73.6% of the injuries. School-going children were most commonly affected (60.8%). Distinctive injuries were noted such as abdominal wall hernias and delayed bladder perforation. All solid organ injury irrespective of grade treated conservatively. Forty percent of the children required surgical intervention. Five patients after laparotomy were found to have surgical conditions unrelated to trauma, whereas another 14 required delayed surgery. Five patients had injuries secondary to sexual abuse. All except two patients were discharged in a satisfactory condition and are doing well in the follow-up., Conclusion: In spite of extensive injuries and the need for multiple surgeries, children with trauma have a good prognosis. Close observation during admission and also in follow-up are essential, as many patients may require delayed surgery ≥1 week from injury., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Indian Association of Pediatric Surgeons.)
- Published
- 2020
- Full Text
- View/download PDF
41. Not All Pediatric Bladder Masses are Rhabdomyosarcoma: Report of a Rare Case With Review of the Literature.
- Author
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Mitra S, Joshi R, Gupta K, and Mahajan JK
- Subjects
- Child, Humans, Male, Leiomyoma metabolism, Leiomyoma pathology, Rhabdomyosarcoma metabolism, Rhabdomyosarcoma pathology, Urinary Bladder Neoplasms metabolism, Urinary Bladder Neoplasms pathology
- Abstract
Leiomyoma of the urinary bladder in the pediatric age group is one of the rarest tumors with only 2 case reports in the English literature. Rhabdomyosarcoma is the commonest tumor at this site in this age group. It needs to be distinguished from rhabdomyosarcoma by histomorphology for appropriate treatment and management. We report the third case of urinary bladder leiomyoma arising in a 6-year-old boy with a short review of the literature.
- Published
- 2019
- Full Text
- View/download PDF
42. Acquired-B phenomenon in a neonate presenting with necrotizing enterocolitis.
- Author
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Kaur A, Jain A, Marwaha N, Mahajan JK, and Sharma RR
- Subjects
- Enterocolitis, Necrotizing pathology, Female, Humans, Infant, Newborn, Enterocolitis, Necrotizing diagnosis
- Abstract
Objective: We are reporting a case of acquired B phenomenon in a 14 days old pre-term baby presenting with necrotizing enterocolitis (NEC) where it was detected as an ABO discrepancy., Method: The forward and reverse grouping was done using tube technique as well as column agglutination technique (ABD card and LISS Coombs AHG gel cards, Biorad, Switzerland). The direct antiglobulin test (DAT) was also done on gel card. Further work up was done using acidified (0.1 N HCl) anti-B (pH 6-6.5) polyclonal anti-B (from group A donors) for resolution of ABO discrepancy., Results: The forward grouping was AB RhD positive with a 'mixed-field' agglutination with anti-B. The reverse grouping using pooled A cells, B cells and O cells gave 'negative' result with both the techniques. Anti-A1 gave 2+ agglutination, anti-H gave 1+ agglutination and autologous control was negative. The DAT was also negative. The patient's previous group on day 1 of life was A RhD positive and had received 1 PRBC (pedibag) transfusion. As the patient's blood culture was positive for Klebsiella pneumoniae, it could have contributed to 'acquired-B' phenomenon. Acidified (0.1 N HCl) anti-B (pH 6-6.5) and polyclonal anti-B yielded no agglutination with patient red cells. The patient was kept on antibiotics subsequently and the blood group after 3 weeks was found to be A RhD positive., Conclusion: This case of 'acquired-B' phenomenon in a neonate with NEC emphasizes the relevance of clinical findings as a guide to resolve blood group discrepancy and deciding further transfusion strategy., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
43. Hepatoblastoma with Precocious Puberty.
- Author
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Yhoshu E, Lone YA, Mahajan JK, and Singh UB
- Abstract
Hepatoblastoma (HB), a primary liver tumor of childhood, is often accompanied by raised levels of alpha-fetoprotein (α-FP). Rarely, the beta-human chorionic gonadotropin (β-hCG) levels may also be elevated, which can cause peripheral precocious puberty (PPP). We report a case of HB with precocious puberty wherein hormonal assays showed an increase in α-FP, β-hCG, and testosterone levels, and suppression of follicle-stimulating and luteinizing hormone levels. After chemotherapy and surgery, α-FP, β-hCG, and testosterone levels normalized, and the signs of virilization did not progress further. New therapeutic approaches have made a previously reported grim prognosis of virilizing HB, more favorable now. In the assessment of PPP, the possibility of a tumoral source for the hormones should also be considered., Competing Interests: There are no conflicts of interest.
- Published
- 2019
- Full Text
- View/download PDF
44. Choroid plexus cysts-antenatal course and postnatal outcome in a tertiary hospital in North India.
- Author
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Yhoshu E, Mahajan JK, and Singh UB
- Subjects
- Central Nervous System Cysts diagnostic imaging, Choroid Plexus Neoplasms diagnostic imaging, Female, Humans, India, Pregnancy, Ultrasonography, Prenatal, Central Nervous System Cysts pathology, Choroid Plexus Neoplasms pathology, Neoplasm Regression, Spontaneous
- Abstract
Purpose: To assess the gestational course and postnatal outcome of antenatally diagnosed choroid plexus cysts., Methods: From January 2015 to October 2017, mothers carrying foetuses with choroid plexus cysts (CPCs) were followed up prospectively till delivery, and subsequent postnatal assessment of all the babies was done. Progress of the lesions was monitored during pregnancy with ultrasound (USG) scans and postnatally analysed with clinical assessment and USG examination of the cranium., Results: A total of 67 mothers of antenatally diagnosed CPCs were referred to the Paediatric Surgery Unit for opinion. Mean gestational age at the time of diagnosis was 19 ± 2.1 weeks (17-28 weeks) while mean age of the mothers at the time of referral was 26 ± 3.3 years (19-35 years). Sixty four mothers have undergone repeat antenatal scans after the diagnosis, and the CPCs disappeared completely in 60 (93.8%) of them. The CPCs persisted but reduced in size in 2 (4.1%), and the other 2 have been lost to follow-up. Thirty eight patients (56.7%) have unilateral CPCs. Mean size of cysts is 6.08 ± 3.0 mm (2.4‑14.8 mm). One foetus, in which the CPC disappeared antenatally, developed it again on the postnatal scans, but is doing well on follow-up. Thirteen babies (19.4%) have other associated congenital malformations as well., Conclusions: CPCs may involve one or both ventricles and disappear in approximately 95% of the cases, mostly within 2 months from the diagnosis. The size of the cyst has no relation to its rate of disappearance. Postnatal persistence of CPCs is uncommon and the neurological sequel is unlikely; hence, prospective parents should be reassured accordingly.
- Published
- 2018
- Full Text
- View/download PDF
45. Omphalocele and epigastric heteropagus: implications and treatment.
- Author
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Malik M, Bahadur Singh U, Hedge S, Mahajan JK, and Samujh R
- Abstract
In heteropagus twins, the parasitic twin is incompletely formed which is attached to the autosite. We report a case of epigastric heteropagus twins with omphalocele. The parasite had two lower limbs, a rudimentary upper limb, genitalia with developed phallus and scrotum but absent testis. An omphalocele was present just below the attachment of the parasitic twin. A single kidney with ureter and a bladder filled with urine seen during exploration. The parasite bowel was attached to a sleeve of liver tissue from the autosite within the omphalocele sac and this connection was also the main source of its blood supply. Less than 20 cases of omphalocele with EH have been reported previously. The thin sac with underlying adherent bowel led us to go ahead with surgery in the neonatal period for both, excision of epigastric heteropagus and omphalocele repair. The rectus sheath around the omphalocele sac helped in the final wound closure.
- Published
- 2018
- Full Text
- View/download PDF
46. Pen Cap Aspirations: Maneuvering for Successful Extraction.
- Author
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Mahajan JK and Rao SG
- Abstract
Aim of this study was to analyze the therapeutic approach with enhanced success of bronchoscopy. We retrospectively analyzed the results of bronchoscopic extraction of pen cap aspirations in our unit from 2000 to 2014. Out of 239 bronchoscopies performed for foreign bodies in airways, there were 8 cases of pen cap aspirations. All 8 were males and age ranged from 5 to 11 years. Seven cases had definitive history, while one patient had a history of chronic respiratory ailment. The foreign bodies were lodged in right and left bronchi in four cases each and seven had their open-end toward the proximal airways. Bronchoscopic extraction was successful in seven patients. The maneuver of rotating the optical forceps by 90 degrees so as to align the pen cap with the vocal cords resulted in success in all the cases. One patient underwent thoracotomy and bronchotomy for removal. Pen cap aspirations occur in school-going children. Aligning the optical forceps with vocal cords during extraction avoids the need for tracheostomy or thoracotomy.
- Published
- 2018
- Full Text
- View/download PDF
47. Erb's palsy complicating a case of annular pancreas.
- Author
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Hegde S, Bawa M, Mahajan JK, and Rao KLN
- Subjects
- Abnormalities, Multiple diagnosis, Brachial Plexus Neuropathies diagnosis, Delayed Diagnosis, Diagnostic Errors, Diaphragmatic Eventration diagnostic imaging, Humans, Infant, Infant, Newborn, Male, Pneumoperitoneum etiology, Brachial Plexus Neuropathies complications, Diaphragmatic Eventration etiology, Duodenal Diseases etiology, Intestinal Obstruction etiology, Pancreas abnormalities, Pancreatic Diseases complications
- Abstract
We report an unusual presentation of annular pancreas with pneumoperitoneum in a newborn with an associated left sided Erb's palsy. The neurological deficit caused considerable confusion in the diagnosis and unexpected complications after surgery. We highlight the importance of clinical examination and the complications that an Erb's palsy can cause. This unusual triad of Erb's palsy, eventration of diaphragm and annular pancreas has hitherto not been described in literature.
- Published
- 2018
- Full Text
- View/download PDF
48. Is urodynamic evaluation a must in all operated cases of open neural tube defects.
- Author
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Bawa M, Dash V, Kalavant A, Mahajan JK, and Rao KLN
- Subjects
- Child, Child, Preschool, Female, Humans, Male, Neural Tube Defects surgery, Urinary Bladder physiopathology, Urinary Bladder, Neurogenic diagnosis, Urinary Bladder, Neurogenic physiopathology, Urodynamics
- Abstract
Background: Spina bifida is a common cause of pediatric neurogenic bladder. It causes renal failure in almost 100% of patients if the associated detrusor sphincter dyssynergia (DSD) is inadequately managed. Detrusor instability and high detrusor pressures (Figure) have been implicated as the major factors predictive of renal damage in these patients. Urodynamic studies provide early identification of "at risk" kidneys so that appropriate intervention can be made. However, the role in post-operative patients of spina bifida who have no clinical manifestations remains unclear., Objective: To study the bladder dynamics in asymptomatic post-operative patients of spina bifida and to determine whether routine urodynamic study is justifiable., Material and Methods: Urodynamics was performed on 15 operated patients of spina bifida who did not have any neurological deficit and were asymptomatic., Results: The mean age of the patients was 4.97 years. None of the patients had any urological complaints with their ultrasonography being normal. None had scars on nuclear scan. Of the 15 patients, 12 (80%) had abnormal findings on urodynamic assessment. Three patients (20%) had detrusor pressures greater than 40 cm of H
2 O. One patient had significant residual urine and detrusor instability., Discussion: The use of urodynamic studies in asymptomatic patients of spina bifida remains controversial, with one school of thought advocating early invasive urodynamic testing. In contrast, some favor noninvasive sonological monitoring, reserving invasive tests only for patients with renal tract dilatation. In our subset of patients none had renal tract dilatation but three patients (20%) had "at risk" bladders. These patients would benefit from early intervention aimed at renal preservation. The study is limited by a small sample size because of the relative rarity of the patient profile included. A further multicenter study with a case-control design could conclusively indicate the role of urodynamic testing in these patients., Conclusion: Patients of spina bifida, even when asymptomatic, have a high incidence of unsafe bladders. Early identification and appropriate measures can protect kidneys from long-term damage, hence urodynamic profiling is mandatory for identification of potentially high-risk bladders., (Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)- Published
- 2017
- Full Text
- View/download PDF
49. Blunt Trauma Pancreas in Children: Is Non-Operative Management Appropriate for All Grades?
- Author
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Garg RK and Mahajan JK
- Abstract
Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries., Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed., Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children. Only 3 patients had associated injuries and all were haemodynamically stable. Serum amylase levels were raised in 12 patients at admission which ranged from 400-1,000 IU. Computed tomography scan made a correct diagnosis in 14 patients. Grades of the injury varied from grade I-V (1, 3, 6, 4, 1 patients respectively). Fourteen patients were managed conservatively. One patient underwent laparotomy for suspected superior mesenteric hematoma. The average duration of enteral feeds was 3.7 days and of hospital stay was 9.4 days. Six patients formed pancreatic pseudocysts; two were managed conservatively while the other four underwent cystogastrostomy. The patients were followed up for a period of 1-12 years. All remained asymptomatic and none had exocrine or endocrine deficiencies., Conclusion: Non-operative treatment for isolated blunt trauma of pancreas in children may be safely followed for all the grades of injury; if associated injuries requiring surgical intervention are ruled out with a good quality imaging and the patients are hemodynamically stable. It did not increase the hospital stay and morbidity and avoided operative intervention on acutely injured pancreas.
- Published
- 2017
- Full Text
- View/download PDF
50. Periurethral Abscess in a Neonate.
- Author
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Singh UB and Mahajan JK
- Published
- 2017
- Full Text
- View/download PDF
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