143 results on '"Sangeeta Khanna"'
Search Results
2. Adhatoda vasica and Tinospora cordifolia extracts ameliorate clinical and molecular markers in mild COVID-19 patients: a randomized open-label three-armed study
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Mukta Verma, Neha Rawat, Ritu Rani, Manju Singh, Aditi Choudhary, Sarfaraz Abbasi, Manish Kumar, Sachin Kumar, Ankur Tanwar, Bishnu Raman Misir, Sangeeta Khanna, Anurag Agrawal, Mohammed Faruq, Shalini Rai, Richa Tripathi, Anil Kumar, Mukta Pujani, Meera Bhojani, Anil Kumar Pandey, Tanuja Nesari, and Bhavana Prasher
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COVID-19 ,Clinical trial ,Adhatoda vasica ,Tinospora cordifolia ,Anti-hypoxic ,Anti-inflammatory ,Medicine - Abstract
Abstract Background SARS-CoV-2 infections caused mild-to-moderate illness. However, a sizable portion of infected people experience a rapid progression of hyper-inflammatory and hypoxic respiratory illness that necessitates an effective and safer remedy to combat COVID-19. Methods A total of 150 COVID-19-positive patients with no to mild symptoms, between the age groups 19–65 years were enrolled in this randomized, open-labeled three-armed clinical trial. Among them, 136 patients completed the study with RT-PCR negative reports. The patients received herbal drugs orally (Group A (Adhatoda vasica; AV; 500 mg; n = 50); Group B (Tinospora cordifolia; TC; 500 mg; n = 43), and Group C (AV + TC; 250 mg each; n = 43)) for 14 days. Clinical symptoms, vital parameters, and viral clearance were taken as primary outcomes, and biochemical, hematological parameters, cytokines, and biomarkers were evaluated at three time points as secondary outcomes. Results We found that the mean viral clearance time was 13.92 days (95% confidence interval [CI] 12.85–14.99) in Group A, 13.44 days (95% confidence interval [CI] 12.14–14.74) in Group B, and 11.86 days (95% confidence interval [CI] 10.62–13.11) days in Group C. Over a period of 14 days, the mean temperature in Groups A, and B significantly decreased linearly. In Group A, during the trial period, eosinophils, and PT/INR increased significantly, while monocytes, SGOT, globulin, serum ferritin, and HIF-1α, a marker of hypoxia reduced significantly. On the other hand, in Group B hsCRP decreased at mid-treatment. Eosinophil levels increased in Group C during the treatment, while MCP-3 levels were significantly reduced. Conclusions All the patients of the three-armed interventions recovered from COVID-19 and none of them reported any adverse effects from the drugs. Group C patients (AV + TC) resulted in a quicker viral clearance as compared to the other two groups. We provide the first clinical report of AV herbal extract acting as a modifier of HIF-1α in COVID-19 patients along with a reduction in levels of ferritin, VEGF, and PT/INR as the markers of hypoxia, inflammation, and thrombosis highlighting the potential use in progression stages, whereas the TC group showed immunomodulatory effects. Trial registration Clinical Trials Database -India (ICMR-NIMS), CTRI/2020/09/028043. Registered 24th September 2020, https://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=47443&EncHid=&modid=&compid=%27,%2747443det%27 Graphical Abstract
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- 2023
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3. Anaesthetic management of robot-assisted laparoscopic surgery
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Chhaya M Suryawanshi, Bhavini Shah, Sangeeta Khanna, Poonam Ghodki, Kanta Bhati, and K V Ashok
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anaesthesia ,laparoscopy ,robotic-assisted surgery ,Anesthesiology ,RD78.3-87.3 - Abstract
Recent trend shows that minimally invasive surgery is in great demand. Robot-assisted procedures have become more popular, as they overcome several drawbacks of traditional laparoscopic techniques. Robotic surgery, however, might necessitate changes in how patients are positioned and how staff and equipment are organised generally, which might go against the traditional approach to anaesthesia care. The novel effects of this technology have the potential to produce paradigm-shifting therapeutic improvements. To provide better anaesthetic treatment and advance patient safety, anaesthesiologists should be aware of these developments by understanding the fundamental components of robotic surgical systems.
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- 2023
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4. Review and practical recommendations for peripheral nerve block during Coronavirus Disease-2019 pandemic
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Sangeeta Khanna and G V Krishna Prasad
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aerosol spread ,coronavirus disease-2019 ,general anesthesia ,peripheral nerve block ,safety ,severe acute respiratory syndrome coronavirus 2 ,Medicine - Abstract
Coronavirus disease-2019 (COVID-19) was announced as a global pandemic by the World Health Organization on March 11, 2020 due to its rapid spread and multinational involvement. Operating room preparedness in these times should encompass increased vigilance, protective measures, and alternative procedures in an effort to mitigate the spread from a proven or suspected case. Specifically, by reducing aerosol-generating procedures as in general anesthesia, anesthesiologists can decrease exposure to patient's respiratory secretions and transmission of virus to the health-care professional and other patients. The Interoperability Standards Advisory in its advisory has also recommended regional anesthesia over general anesthesia as one of the steps that can reduce aerosol spread. Further, to restrict airway manipulation, peripheral nerve blocks (PNB) should be considered whenever possible in suspected or confirmed cases of COVID-19 undergoing surgery. PNB has the advantage of maintenance of respiratory functions, prevention of aerosolization, and so preventing viral transmission. This article explores the practical information and suggested measures for conducting PNB in COVID-19 patients with suggestions toward resource planning, clinical environment modification, equipment preparation, supply of drugs, choosing of correct personal protective equipment, safe PNB procedures, anesthesia monitoring, and postanesthetic care. By addressing these issues, infection control during anesthesia can be achieved and which is essential in the present era with emerging infection and novel pathogens such as coronavirus 2 causing the severe acute respiratory syndrome. Thus, framing a structured protocol for PNB among these patients is essential for the best perioperative outcome.
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- 2022
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5. Peripheral nerve block (FLOS block) for intraoperative anesthesia in total knee arthroplasty: An observational study
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Sangeeta Khanna, Biraj Gogoi, Sharma Vipin Jaishree, and G V Krishna Prasad
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flos block ,pain control ,peripheral nerve block ,total knee arthroplasty ,Medicine - Abstract
Background: Peripheral nerve blocks (PNBs) are generally used to provide postoperative analgesia after total knee arthroplasty (TKA) and other lower extremity procedures; these blocks are used rarely for intraoperative anesthesia. We present here, the patients who underwent TKA under PNBs (FLOS Block). FLOS block is nothing but femoral, lateral cutaneous femoral nerve, obturator, and sciatic nerve block. Materials and Methods: A total of 41 patients participated in the study for TKA using PNB, FLOS block. All the patients received standardized anesthesia and analgesia upon hospitalization. Outcome evaluations included the visual analog scale (VAS) scores during surgery, activity at rest, postoperative blood pressure, and heart rate, also the sedation for femoral, lateral cutaneous femoral nerve obturator and sciatic nerve (FLOS) blocks. Compared with neuraxial (spinal/epidural) anesthesia, PNB (FLOS Block) minimizes hypotension, minimizes urinary retention, improves patient satisfaction, ambulation restrictions, and eliminates the risk of spinal hematoma and infection. Results: The finding suggests a decreased requirement of opioids in the PNB technique (FLOS Block). Pain scores, assessed by subjective VAS scale, were accurately handled in all the patients reviewed, with good pain control with PNB (FLOS Block). PNB (FLOS Block) provided stable hemodynamic, prolonged, and better postoperative analgesia. Intraoperative anesthesia was very satisfactory for surgery. The requirement of total doses of rescue analgesics, VAS score peroperatively for 48 h, the incidence of side effects, and complications were very few and acceptable. Conclusion: A femoral, sciatic nerve block with obturator and lateral femoral cutaneous nerve block may be an option to the spinal epidural anesthesia in the patients undergoing TKA. PNB (FLOS Block) showed similar patient satisfaction and postoperative analgesia to spinal-epidural anesthesia.
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- 2021
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6. Peripheral nerve blocks in trauma patients: Recent updates and improving patient outcomes: A narrative review
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G. V. Krishna Prasad, Sangeeta Khanna, and Vipin Sharma
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nerve block ,regional anesthesia ,trauma ,outcomes ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is severe, but is often undertreated in trauma population. Opioids are widely used to treat pain in trauma patients but being associated with undesirable effects. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement and is safe and easy to perform. Specific populations that have shown benefits (including decreased morbidity and mortality) with regional analgesic techniques include those with fractured ribs and femur and hip fractures and patients undergoing digital replantation. The use of regional anesthesia in patients at risk for compartment syndrome is controversial; although the data is sparse, there is no evidence that peripheral nerve blocks delay the diagnosis. The benefit of regional analgesia is most evident when it is initiated as early as possible. The performance of nerve blocks both in the emergency room and in the field has been shown to provide quality pain relief with an excellent safety profile.
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- 2020
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7. Review of adjuvants to local anesthetics in peripheral nerve blocks: Current and future trends
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G V Krishna Prasad, Sangeeta Khanna, and Sharma Vipin Jaishree
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additive ,alpha-2 agonists ,analgesia ,opioids ,peripheral nerve block ,steroid ,Anesthesiology ,RD78.3-87.3 - Abstract
In recent anesthetic practice, peripheral nerve blocks (PNBs) are used extensively for surgical anesthesia and nonsurgical analgesia. PNBs offer many benefits over other anesthetic techniques in a certain population of patients, and in some specific clinical setting, that may contribute to faster and safer pain relief, increased patient satisfaction, reduced hospital stay, and decreased overall healthcare cost. The technique involves the injection of the anesthetic in the vicinity of a specific nerve or bundle of nerves to block the sensation of pain transmitting to a specific portion of the body. However, the length of analgesia when a single anesthetic is used for PNB may not last long. Therefore, the practice of adding an additional agent called adjuvant has been evolved to prolong the analgesic effect. There are many such adjuvants available that are clinically being used for this purpose imparting great efficacy and safety to the anesthetic process. The adjuvants molecules are generally classified as opioids, alpha-2 agonist, steroids, etc. Most of them are safe to use and show little or no adverse event related to neurotoxicity and tissue damage. Although there is extensive use of such adjuvants in the clinical field, none of the molecules is approved by the FDA and is used as an off-label drug. The risk to benefit ratio must be assessed while using such an agent. This review will try to delineate the basic need of adjuvant in peripheral nerve block and will discuss the advantages and limitations of using different adjuvants and will discuss the future prospect of such application.
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- 2020
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8. Acute perioperative hyperlactatemia in oncoplastic reconstructive surgeries: What is the significance?
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Preety M Roy, Kamal Bharti, Sudha Sinha, Sangeeta Khanna, and Yatin Mehta
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free flap surgery ,lactate ,oncoplastic surgery ,reconstructive ,Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Abstract
Background and Aims: We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery. Material and Methods: A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit. Results: The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups. Conclusion: Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
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- 2021
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9. Airway exchange catheter inducing pneumothorax during reintubation: A rare complication
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Sangeeta Khanna, Sonia Bhan, Kaminder Bir Kaur, and Debashish Paul
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airway exchange catheters ,complications ,pneumothorax ,Medicine - Abstract
Airway exchange catheters (AECs) are a safe option for exchanging an endotracheal tube (ETT) or in the trial to extubate a patient from ventilation in the intensive care unit (ICU). The complication with AEC is underreported. Pneumothorax is a known complication for instrumentation by AEC in the airway. However, having a pneumothorax complication while placing the AEC in expert hands and with all safety precautions is very rare. We report a case of developing pneumothorax while exchanging an ETT in the ICU. Early clinical diagnosis and remedial measures helped us to save the patient. It is interesting as we did not encounter any difficulties while placing the AEC with no significant change in ventilation settings. We feel that highlighting this case will help the physician in the emergency and in the ICU to have a strong suspicion of pneumothorax while using AEC.
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- 2020
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10. A randomized study to compare palonosetron with ondansetron for prevention of postoperative nausea and vomiting following middle ear surgeries
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Shubhangi Sharma, Sangeeta Khanna, Jyotirmoy Das, Yatin Mehta, and Kumud Kumar Handa
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Middle ear surgery ,ondansetron ,palonosetron ,postoperative nausea and vomiting ,Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Abstract
Background and Aims: Postoperative nausea and vomiting (PONV) has multifactorial etiology. It is a commonly encountered morbidity after anesthesia specially following middle ear surgery. Various antiemetic medications have been tried with mixed responses. Palonosetron is a newer 5-hydroxytryptamine (5-HT3) receptor antagonist marketed for PONV prophylaxis. This study was designed to compare the efficacy of palonosetron and ondansetron in preventing PONV after middle ear surgeries. Material and Methods: One hundred patients of ASA class 1 or 2, aged 18 years and above, weighing between 40 and 90 kg scheduled for elective middle ear surgeries were randomly assigned into palonosetron group (n = 50) and ondansetron group (n = 50). Palonosetron was administered in dose of 1 mcg/kg maximum up to 75 mcg and ondansetron in dose of 0.1 mg/kg maximum up to 8 mg. Intraoperative monitoring of QTc interval was also done to see any significant change after the antiemetic administration. The incidence of nausea, vomiting, and side effects were recorded over 2, 12, and 24 hours postoperatively. All parameters were compared between the two groups as mean ± standard deviation and as count (%). Two sided P values of
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- 2019
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11. Bullet in tracheobronchial tree without lung contusion removed by fibreoptic bronchoscopy in two parts
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Ashish K. Prakash, Anand Jaiswal, Ankit Aggarwal, B. Datta, Sangeeta Khanna, K.K. Handa, and Yatin Mehta
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Diseases of the respiratory system ,RC705-779 - Abstract
A person presented with multiple gunshot injury. Chest x-ray & CT whole body trauma protocol was done which showed multiples pellets of bullet in abdomen and one bullet in elbow according to entry wound. There was an entry wound without any bullet in left maxillofacial region however there was no exit wound. A bullet was noticed in tracheobronchial tree. There was no pneumothorax any signs of chest trauma or any pneumomediastinum. It is assumed that the bullet first hit the left cheek (maxilla) and lost its momentum. As the patient lost consciousness and had a fall leading to inhalation (aspiration) of bullet in the airway. As per ballistic experts it was basically a jacketed metallic bullet. As bullet moved in airway, the outer metallic core reached the trachea near carina and the soft metallic core slipped more distally to right main bronchus and bronchus intermedius. While inspection the outer metallic capsule was seen in trachea just above carina which was hollow and was gently removed with the help of foreign body forceps. The core was removed with dormia basket without any mucosal tear. The favorable outcome can be attributed as patient had no lung contusion or chest trauma and bullet was inhaled which was not very old. The evolution of bronchoscopy started with rigid one but the fibreoptic bronchoscopy (FOB) has revolutionized the pulmonary interventions. The FOB can be used with minimal traumas under local anesthesia resulting in markedly reduced morbidity and mortality.
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- 2019
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12. Ellis–Van Creveld syndrome and its anesthetic implications
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Rajesh Gupta, Sangeeta Khanna, Meera Luthra, and Yatin Mehta
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Anesthesia ,autosomal recessive ,chondroectodermal dysplasia ,disorders ,dwarfism ,Ellis–Van Creveld syndrome ,mesoectodermal dysplasia ,pediatric ,polydactyly ,Anesthesiology ,RD78.3-87.3 - Abstract
Ellis–Van-Creveld syndrome (EVC), otherwise known as chondroectodermal or mesoectodermal dysplasia, is an autosomal recessive disorder found in the Amish population of Pennsylvania in the USA, with the incidence of 1:244,000 for the general population. The classical syndrome encompasses a tetrad of clinical manifestations, including di sproportionate dwarfism, postaxial polydactyly, ectodermal dysplasia (mainly affecting the teeth, nails, and hair), and congenital heart disease (CHD). Additional involvement may occur in organs of endodermal origin, such as the pulmonary, renal, gastrointestinal (hepatic and pancreatic), hematologic, and central nervous systems. The perioperative care of a 2-year girl who underwent surgical correction of supernumerary digits is presented here.
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- 2018
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13. Quadratus lumborum block for post-operative pain relief in patient with Prune belly syndrome
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Chitra Garg, Sangeeta Khanna, and Yatin Mehta
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Abdominal surgery ,quadratus lumborum block ,prune belly syndrome ,ultrasound ,Anesthesiology ,RD78.3-87.3 - Abstract
Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10–T12 segments, providing only partial pain relief. The new quadratus lumborum (QL) block has the advantage of providing wider sensory block from T6 to L1 and thus has an evolving role in opioid-free anaesthesia. Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems. We report a case of a young male with Prune belly syndrome, who had a pain-free post-operative period after high inguinal orchidectomy with unilateral QL block.
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- 2017
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14. Perioperative management lessons learned from the robot-assisted thymectomy project
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Sangeeta Deka, Jyotirmoy Das, Sangeeta Khanna, Yatin Mehta, and Ali Zamir Khan
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Anesthesiology ,RD78.3-87.3 - Published
- 2017
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15. A chance encounter with a case of hypertrophic cardiomyopathy
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Sangeeta Khanna, Krishna Prasad, Vipin J Sharma, and Nitul M Bewal
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Anesthesiology ,RD78.3-87.3 - Published
- 2019
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16. Robot Assisted Renal Auto Transplantation: A Case Based Discussion of Unique Anaesthetic Considerations
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Praveen Gupta, Jyotirmoy Das, Sangeeta Khanna, Sudhir Kumar, Yatin Mehta, and Rajesh Ahlawat
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Auto transplantation ,Robot ,Steep trendelenburg ,Chronic kidney disease ,Anaesthesia ,Anesthesiology ,RD78.3-87.3 - Abstract
Laparoscopic renal autotransplantation has serious perturbations on the body's homeostasis due to its non physiological positioning, use of pneumoperitoneum, changing fluid strategy at different points of time and on-going steps to maintain optimal environment for the transplanted kidney. Generally speaking, the anaesthetic management of renal auto-transplantation by open technique is not very complex and the perioperative management can be categorized in the intermediate level of clinical skill requirement. Adding to the comfort of the anaesthesiologist is the fact that these patients are not in end stage renal disease state and does not manifest the comorbidities, multisystem involvement and technical complexities of long term renal dysfunction and renal replacement therapy. In our case report surgeons used the da Vinci surgical robotic system for laparoscopic transplantation of the kidney at a new site. In this article we discuss the anaesthetic challenges of robot assisted laparoscopic renal auto-transplantation along with a description of our index case.
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- 2015
17. A child of Williams-Beuren syndrome for inguinal hernia repair: Perioperative management concerns
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Sangeeta Deka, Jyotirmoy Das, Sangeeta Khanna, Yatin Mehta, and Meera Luthra
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Myocardial ischemia ,pulmonary stenosis ,sudden cardiac death ,supravalvular aortic stenosis ,Williams syndrome ,Anesthesiology ,RD78.3-87.3 - Abstract
Williams-Beuren syndrome, commonly known as Williams syndrome (WS), is a multi-organ disorder. The principal anomalies of the syndrome are developmental delay, unusual craniofacial dysmorphic features, and cardiovascular anomalies such as valvular or supravalvular aortic stenosis, pulmonary artery stenosis, and coronary insufficiency. Sudden cardiac death during minor procedures even in the absence of gross cardiovascular pathology is the most dreaded complication in these patients. A 7-year-old child with WS was posted for left-sided inguinal hernia repair under general anesthesia. Our article describes the uneventful perioperative course of the patient and highlights the concerns and complications that may be an integral part with the syndrome.
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- 2016
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18. Anaesthesia management of a case of Jervell and Lange-Nielsen syndrome for minimally invasive bilateral thoracoscopic cervicothoracic sympathectomy
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Preety Mittal Roy, Sangeeta Khanna, Yatin Mehta, and Ali Z Khan
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Cervicothoracic sympathectomy ,long QT syndrome ,ventricular tachycardia ,Anesthesiology ,RD78.3-87.3 - Abstract
Long QT syndrome (LQTS) is an arrhythmogenic cardiac disorder resulting from the malfunction of cardiac ion channels. Patient with LQTS may present with syncope, seizures or sudden cardiac death secondary to polymorphic ventricular tachycardia (VT) or torsades de pointes. Patient may be asymptomatic in the pre-operative period but may develop VT for the first time in operation theatre. We are reporting anaesthetic management of a child with LQTS planned for bilateral thoracoscopic cervicothoracic sympathectomy.
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- 2016
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19. Are we causing the recurrence-impact of perioperative period on long-term cancer prognosis: Review of current evidence and practice
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Jyotirmoy Das, Sudhir Kumar, Sangeeta Khanna, and Yatin Mehta
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Anesthesia ,cancer recurrence ,cytokines ,hypothalamic-pituitary-adrenal axis ,immunomodulation ,interleukins ,oncogenesis ,stress response ,Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Abstract
Newer developments in the field of chemotherapeutic drug regimes, radiotherapy, and surgical techniques have improved the prognosis of cancer patients tremendously. Today increasing numbers of patients with aggressive disease are posted for surgical resection. The advances in reconstructive flap surgery offer the patient a near normal dignified postresection life. Hence, the expectations from the patients are also on the rise. Anesthetic challenges known in oncosurgery are that of difficult airway, maintenance of hemodynamics and temperature during long surgical hours, pain management, and postoperative intensive care management. But, recently acquired data raised the possibility of the anesthetic technique and conduct of perioperative period as a possible contributory factor in the growth and possible recurrence of the primary tumor. The foundation of the concept is somewhat fragile and not supported by conclusive evidence. In fact, like any other controversial topic in medicine, contradictory reports of the favorable effects of anesthetic technique and medications are plenty in the literature. This is the basis of our article where we have analyzed the current evidence available in the literature and how these and the forthcoming large scale studies may revolutionize the practice of oncoanesthesia.
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- 2014
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20. An incidental finding of endotracheal tube obstruction at the level where inflation line enters into the tube
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Arvind Kumar, Sangeeta Khanna, and Yatin Mehta
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Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Published
- 2018
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21. Absent upper blind Pouch in a case of tracheo-esophageal fistula
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Man Mohan Harjai, Sachendra Badal, Sangeeta Khanna, and Ajit Kumar Singh
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Absent upper Pouch ,laryngeal atresia ,VACTERL association and tracheo-esophageal fistula ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation, which is difficult even in expert hand. We present a newborn with suspected tracheo-esophageal fistula that was diagnosed intraoperatively to have absent upper blind pouch of the esophagus and on autopsy found to have laryngeal atresia with absent vocal cords and a common aerodigestive tract continuing distally with trachea. The neonate was ventilated with endotracheal tube (ETT) placement which in retrospect we came to know that it was in the esophagus. The neonate also had associated multiple congenital anomalies of VACTERL association. The importance of teamwork between neonatologist, pediatric surgeon, anesthesiologist, and radiologist is highlighted for diagnosis and management of such rare cases.
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- 2015
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22. Combined mucopolysaccharidosis type VI and congenital adrenal hyperplasia in a child: Anesthetic considerations
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Abhishek Bansal, Jyotirmoy Das, Raj Kumar, Sangeeta Khanna, Harsh Sapra, and Yatin Mehta
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Congenital adrenal hyperplasia ,mucopolysaccharidosis ,steroid supplementation ,stress dose ,Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Abstract
We present a child posted for magnetic resonance imaging of brain under general anesthesia with the rare combination of mucopolysachharidosis type VI and congenital adrenal hyperplasia. The presence of both these disorders has important anesthetic implications. The pathophysiology of this rare combination of disease is reviewed with emphasis on the anesthesia management.
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- 2012
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23. A novel technique to prevent endobronchial spillage during video assisted thoracoscopic lobectomy
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Anand Sharma, Sudha Sinha, Sangeeta Khanna, Yatin Mehta, Shaiwal Khandelwal, and Ali Zamir Khan
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Aspergilloma ,Fogarty catheter ,Lung isolation ,Anesthesiology ,RD78.3-87.3 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Endobronchial spillage of fungal material into normal lung can infect it and the spillage of fungal material should be prevented during surgery. We report our experience of a patient who presented for right upper lobectomy with bronchiectasis, tubercular destruction and subsequent aspergilloma. A 4F Fogarty catheter was introduced through the tracheal lumen of the left sided endobronchial double lumen tube (DLT) to occlude the bronchus intermedius to prevent spillage of aspergilloma into the non-infected lower and middle lobes of the right lung. The Fogarty catheter was pulled into the trachea just before stapling the bronchus; thereafter, right upper lobectomy was completed successfully. The patient was extubated uneventfully and transferred to post-operative recovery ward. The endobronchial blockage of the intermediate bronchus of the operative lung by the Fogarty catheter and isolation of the left lung by the DLT prevented spillage of aspergilloma in both the operative right lung and the left lung.
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- 2014
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24. The Diagnosis and Treatment of Infantile Nystagmus Syndrome (INS)
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Sangeeta Khanna and Louis F. Dell'Osso
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Technology ,Medicine ,Science - Abstract
The successful treatment of infantile nystagmus syndrome (INS) depends primarily on accurate and repeatable diagnosis of the type(s) of nystagmus present as well as their variation with gaze and convergence angles or fixating eye. Research over the past 40 years has demonstrated that the only way to achieve both is by making and analyzing ocular motility recordings. Determination of the direct effects of peripheral and central INS therapies can only be made by pre- and post-therapy comparisons of the nystagmus characteristics, specifically of the quality of the foveation periods within each cycle. If one is only interested in cosmetic improvements, diminution of the nystagmus amplitude is all that need be measured. However, if improvement of visual function is the primary goal of therapy, then measurement of the pre- and post-therapy foveation quality must be made, both in primary position and over a broad range of gaze angles. The use of the eXpanded Nystagmus Acuity Function (NAFX) on nystagmus data yields both an accurate measure of foveation quality and a prediction of maximum potential acuity for the patient's waveform. When used with the patient's measured, pre-therapy visual acuity, the NAFX demonstrates the amount of visual acuity loss that is due to sensory abnormalities, demonstrates the amount due to the nystagmus waveform, and estimates the measured post-therapy acuity for all values of improved NAFX and gaze angles measured. The ability to predict visual acuity improvement was not possible before the use of the NAFX. The failure to incorporate accurate measures of nystagmus waveform and foveation quality into their diagnostic evaluation continues to deprive patients of the best possible standard of care and results in mistaken diagnoses as well as inappropriate and, in some cases, unneeded multiple surgeries.
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- 2006
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25. ′Can′t ventilate′ during surgery: Nightmare for anaesthesiologist
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Preety Mittal Roy, Sangeeta Khanna, Yatin Mehta, and A Z Khan
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Anesthesiology ,RD78.3-87.3 - Published
- 2016
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26. Airway management: Few more lessons to learn
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Preety M Roy, Sudha Sinha, Sangeeta Khanna, and Yatin Mehta
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Anesthesiology ,RD78.3-87.3 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
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27. Use of point of care ultrasound for removal of foreign body: 'Early screening of the neighborhood is the key'
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Jyotirmoy Das, Sangeeta Khanna, Sudhir Kumar, Ali Zamir Khan, and Yatin Mehta
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Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Published
- 2016
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28. The 'Open Jaw' Mask ventilation: An effective technique in patients with loose tooth
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Jyotirmoy Das, Sudhir Kumar, Sangeeta Khanna, and Yatin Mehta
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Anesthesiology ,RD78.3-87.3 - Published
- 2017
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29. Spurious oxygen saturation value: A dilemma for anaesthesiologist
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Amit Goyal, Himanshu Khurana, Sangeeta Khanna, and Yatin Mehta
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Anesthesiology ,RD78.3-87.3 - Published
- 2015
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30. Blood transfusion practices in liver transplantation
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Jyotirmoy Das, Sangeeta Khanna, Sudhir Kumar, and Yatin Mehta
- Subjects
Anesthesiology ,RD78.3-87.3 - Published
- 2015
- Full Text
- View/download PDF
31. Unusual airway foreign body: Vigilance is the price of safety
- Author
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Sushma Barde, Preety Mittal Roy, Sangeeta Khanna, and Yatin Mehta
- Subjects
Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Published
- 2015
- Full Text
- View/download PDF
32. ISACON 2023: Gurugram heralding a new growth in anaesthesia
- Author
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Sangeeta, Khanna and Harsh, Sapra
- Subjects
Anesthesia ,Health - Abstract
Byline: Khanna. Sangeeta, Sapra. Harsh The 70th Annual Conference of the Indian Society of Anaesthesiologists (ISACON 2023) was the first conference to be hosted by the state of Haryana in [...]
- Published
- 2024
33. Wrong gas: Risk of intra-abdominal fire during laparoscopic surgery
- Author
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Bijaya K Shadangi, Sangeeta Khanna, and Yatin Mehta
- Subjects
Anesthesiology ,RD78.3-87.3 - Published
- 2012
- Full Text
- View/download PDF
34. Monitoring of neuromuscular blockade by pulse oximetry tracing: A simple modification of mechanomyographic and acceleromyographic principles
- Author
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Jyotirmoy Das, Sangeeta Khanna, Devalina Goswami, Pawan Kumar Kapoor, and Yatin Mehta
- Subjects
Anesthesiology ,RD78.3-87.3 ,Pharmacy and materia medica ,RS1-441 - Published
- 2011
- Full Text
- View/download PDF
35. Perioperative cardiac failure
- Author
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Yatin Mehta and Sangeeta Khanna
- Subjects
Perioperative ,Heart failure ,Cardiopulmonary bypass ,Anesthesiology ,RD78.3-87.3 - Published
- 2007
36. The Pediatric Optic Neuritis Prospective Outcomes Study
- Author
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Stacy L. Pineles, Robert J. Henderson, Michael X. Repka, Gena Heidary, Grant T. Liu, Amy T. Waldman, Mark S. Borchert, Sangeeta Khanna, Jennifer S. Graves, Janine E. Collinge, Julie A. Conley, Patricia L. Davis, Raymond T. Kraker, Susan A. Cotter, Jonathan M. Holmes, Melinda Y. Chang, Dilshad Contractor, Emily J. Zolfaghari, Aarti Vyas, Tiffany Yuen, Veeral S. Shah, Evelyn A. Paysse, Gihan Romany, Jason H. Peragallo, Judy L. Brower, Aparna Raghuram, Bilal Al Wattar, Ryan Chinn, Srishti Kothari, R. Michael Siatkowski, Maria E. Lim, Alisha N. Brewer, Annette M. Doughty, Sonny W. Icks, Shannon Almeida, Alejandra de Alba Campomanes, Premilla Banwait, Leila Hajkazemshirazi, Yizhuo Bastea-Forte, Jennifer K. Arjona, Jeremy Chen, Karen Cooper, Rafif Ghadban, Sophia M. Chung, Oscar A. Cruz, Traci A. Christenson, Lisa L. Breeding, Dawn M. Govreau, Beth A. Wallis, Brooke E. Geddie, Elisabeth T. Wolinski, Indre M. Rudaitis, Jacqueline Twite, Carrie S. Bloomquist, Sarah R. Laboy, Jackie M. Twite, Michelle V. Doan, Marianne J. Bernardo, Michael C. Brodsky, John J. Chen, Suzanne M. Wernimont, Lindsay L. Czaplewski, Stacy L. Eastman, Moriah A. Keehn, Debbie M. Priebe, Don L. Bremer, Richard P. Golden, Catherine O. Jordan, Mary Lou McGregor, Rachel E. Reem, David L. Rogers, Amanda N. Schreckengost, Sara A. Maletic, Mays A. Dairi, Laura B. Enyedi, Sarah K. Jones, Navajyoti R. Barman, Robert J. House, David A. Nasrazadani, Sean M. Gratton, Justin D. Marsh, Rebecca J. Dent, Lezlie L. Bond, Lori L. Soske, Padmaja Sudhakar, Christi M. Willen, Deborah Taylor, Nathaniel Q. Moliterno, Michael Nsoesie, Shaista Vally, Paul H. Phillips, Robert S. Lowery, Beth Colon, Nancy L. Stotts, Kelly D. To, Collin M. McClelland, Raymond G. Areaux, Ann M. Holleschau, Kim S. Merrill, Luis H. Ospina, Rosanne Superstein, Maryse Thibeault, Helene Gagnon, Sean P. Donahue, Scott T. Ruark, Lisa A. Fraine, Petrice A. Sprouse, Ronald J. Biernacki, Robert A. Avery, Brian J. Forbes, Imran Jivraj, Anita A. Kohli, Meg M. Richter, Agnieshka Baumritter, Ellen B. Mitchell, Ken K. Nischal, Lauren M. Runkel, Bianca Blaha, Whitney Churchfield, Christina Fulwylie, Melissa W. Ko, Luis J. Mejico, Muhammad Iqbal, Catherine E. Attanasio, Lena F. Deb, Courtney B. Goodrich, Alisha M. Hartwell, Jennifer A. Moore, Lisa Bohra, Alexandra O. Apkarian, Elena M. Gianfermi, John D. Roarty, Leemor B. Rotberg, Susan N. Perzyk, Roy W. Beck, Darrell S. Austin, Nicole M. Boyle, Danielle L. Chandler, Patricia L. Connelly, Courtney L. Conner, Trevano W. Dean, Quayleen Donahue, Brooke P. Fimbel, Amra Hercinovic, James E. Hoepner, Joseph D. Kaplon, Zhuokai Li, Gillaine Ortiz, Julianne L. Robinson, Kathleen M. Stutz, David O. Toro, Victoria C. Woodard, Rui Wu, Laura Balcer, Mark Kupersmith, Elizabeth L. Lazar, Amy Waldman, David K. Wallace, Eileen E. Birch, Angela M. Chen, Stephen P. Christiansen, S. Ayse Erzurum, Donald F. Everett, Sharon F. Freedman, William V. Good, Katherine A. Lee, Richard London, Vivian M. Manh, Ruth E. Manny, David G. Morrison, Bonita R. Schweinler, Jayne L. Silver, Lisa C. Verderber, Katherine K. Weise, Ari Green, Marie Diener-West, John D. Baker, Barry Davis, Dale L. Phelps, Stephen W. Poff, Richard A. Saunders, and Lawrence Tychsen
- Subjects
Ophthalmology - Published
- 2022
37. Prevalence of the Infantile Strabismus Complex in Premature Children With and Without Periventricular Leukomalacia
- Author
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Sangeeta Khanna, Aseem Sharma, Fatema Ghasia, and Lawrence Tychsen
- Subjects
Strabismus ,Ophthalmology ,Case-Control Studies ,Leukomalacia, Periventricular ,Infant, Newborn ,Prevalence ,Humans ,Child ,Magnetic Resonance Imaging ,Nystagmus, Pathologic ,Retrospective Studies - Abstract
To determine whether rates of strabismus and associated visuomotor deficits differed among children with different severities of periventricular leukomalacia (PVL).Retrospective, case-control study.Brain magnetic resonance images (MRI) obtained from 98 children aged ≥2 years were analyzed using a standardized scoring system: 67 of 98 had PVL (mean GA 31 weeks) and 31 of 98 did not have PVL (mean GA 29 weeks). Severity of PVL was scored as degree of damage to the posterior optic radiations and the splenium of the corpus callosum on MRI. Ophthalmologic examination data were collated to assess the prevalence of visuomotor deficits and the relationship to PVL severity (grades 1-3, mild to severe).Infantile strabismus was documented in 61% of children with mild, 74% with moderate, and 88% with severe PVL (esotropia: exotropia ratio 3.5:1). Associated ocular motor deficits also increased systematically with PVL severity: latent ("fusion maldevelopment") nystagmus (20%, 47%, and 40%, respectively), dissociated vertical deviation (13%, 28%, and 30%), and nasotemporal pursuit/optokinetic nystagmus asymmetry (23%, 38%, and 54%). Additionally, the prevalence of retrograde optic neuropathy increased with PVL severity (5%, 26%, and 38%). The prevalence of each of these signs was substantially lower in children who had no PVL.Children who suffer PVL are likely to develop the deficits of the infantile strabismus complex. The deficits tend to increase systematically as a function of PVL severity. These findings provide evidence that infantile strabismus is linked to perinatal damage to cerebral vergence and gaze pathways.
- Published
- 2022
38. Pericapsular Nerve Group (PENG) Block for Hip Fracture Surgeries: An Observational Study
- Author
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Sangeeta Khanna, Krishna Prasad, and Vipin Sharma
- Subjects
General Medicine ,General Pharmacology, Toxicology and Pharmaceutics ,General Biochemistry, Genetics and Molecular Biology - Published
- 2021
39. Normalization of electroretinogram and symptom resolution of melanoma-associated retinopathy with negative autoantibodies after treatment with programmed death-1 (PD-1) inhibitors for metastatic melanoma
- Author
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Karam Khaddour, Sangeeta Khanna, Michael Ansstas, Ishaan Jakhar, Sonika Dahiya, Laurin Council, and George Ansstas
- Subjects
Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Programmed Cell Death 1 Receptor ,Immunology ,Pembrolizumab ,Metastatic melanoma ,Epitope ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Immune system ,Positron Emission Tomography Computed Tomography ,Internal medicine ,Electroretinography ,medicine ,Humans ,Immunology and Allergy ,Molecular Targeted Therapy ,Paraneoplastic ,Immune Checkpoint Inhibitors ,Melanoma ,Aged ,Autoantibodies ,Programmed death-1 inhibitors ,Paraneoplastic Syndromes, Ocular ,business.industry ,Autoantibody ,Retinal ,Immunotherapy ,medicine.disease ,030104 developmental biology ,Membrane protein ,chemistry ,030220 oncology & carcinogenesis ,Original Article ,business ,Melanoma-associated retinopathy ,Retinopathy - Abstract
Melanoma-associated retinopathy (MAR) is a paraneoplastic syndrome that involves the production of autoantibodies which can cross-react with retinal epitopes leading to visual symptoms. Autoantibodies can target intracellular proteins, and only a few are directed against membrane proteins. This discrepancy in autoantibody–protein target can translate into different immune responses (T-cell mediated vs B-cell mediated). Historically, treatment of MAR has focused on surgical reduction or immunosuppressive medication, mainly glucocorticoids. However, tumor resection is not relevant in metastatic melanoma in which MAR is mostly encountered. Moreover, the use of glucocorticoids can reduce the efficacy of immunotherapy. We report the first case to our knowledge with subjective resolution of visual symptoms and objective evidence of normalization of electroretinogram of MAR with undetectable autoantibodies after administration of programmed death-1 (PD-1) inhibitor (pembrolizumab) without the use of surgical reduction or systemic immunosuppression. This case highlights the potential improvement and resolution of negative autoantibody MAR with the use of PD-1 inhibitors and emphasizes the importance of multidisciplinary approach and team discussion to avoid interventions that can decrease immunotherapy-mediated anti-tumor effect.
- Published
- 2021
40. Acute perioperative hyperlactatemia in oncoplastic reconstructive surgeries: What is the significance?
- Author
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Sudha Sinha, Kamal Bharti, Yatin Mehta, Sangeeta Khanna, and Preety Mittal Roy
- Subjects
Reconstructive surgery ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Free flap ,law.invention ,Pharmacy and materia medica ,reconstructive ,Anesthesiology ,law ,medicine ,RD78.3-87.3 ,Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics ,lactate ,business.industry ,oncoplastic surgery ,Retrospective cohort study ,Perioperative ,Intensive care unit ,RS1-441 ,Oncoplastic Surgery ,Anesthesiology and Pain Medicine ,Anesthesia ,Free flap surgery ,Hyperlactatemia ,Original Article ,business - Abstract
Background and Aims: We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery. Material and Methods: A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit. Results: The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups. Conclusion: Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
- Published
- 2021
41. A prospective, randomised, single-blinded controlled trial comparing ultrasound versus nerve stimulator guidance for interscalene block for ambulatory upper limb surgeries
- Author
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Sangeeta Khanna, Rama Gupta, Vivek Gupta, Tarun Gupta, and A.K. Singh
- Subjects
General Medicine - Published
- 2022
42. Severe Vision Loss and Intracranial Hypertension Presenting as Delayed Sequelae of 'Mild' Carbon Monoxide Poisoning
- Author
-
James H. Garcia and Sangeeta Khanna
- Subjects
Hyperbaric Oxygenation ,business.industry ,Carbon monoxide poisoning ,Vision Disorders ,medicine.disease ,Carbon Monoxide Poisoning ,Ophthalmology ,Anesthesia ,Disease Progression ,Humans ,Medicine ,Neurology (clinical) ,Intracranial Hypertension ,business - Published
- 2020
43. Airway Pressure Variations During Robot Assisted Laparoscopic Radical Prostatectomy: Comparative Evaluation of Modified Z Trendelenburg Position and Conventional Steep Trendelenburg Position
- Author
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Amit Goyal, Jyotirmoy Das, Kumari Pallavi, Sangeeta Khanna, Narmada P. Gupta, and Mathangi Krishnakumar
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Trendelenburg position ,Medicine ,Robot assisted laparoscopic radical prostatectomy ,General Medicine ,business ,Airway ,Comparative evaluation ,Surgery - Published
- 2020
44. Peripheral nerve blocks in trauma patients: Recent updates and improving patient outcomes: A narrative review
- Author
-
Sangeeta Khanna, Vipin Sharma, and G V Krishna Prasad
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,medicine.medical_treatment ,Analgesic ,Population ,outcomes ,Industrial and Manufacturing Engineering ,lcsh:RC346-429 ,nerve block ,trauma ,Opioid ,Peripheral nerve ,Replantation ,medicine ,Nerve block ,Femur ,Intensive care medicine ,education ,business ,regional anesthesia ,lcsh:Neurology. Diseases of the nervous system ,medicine.drug ,Cause of death - Abstract
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is severe, but is often undertreated in trauma population. Opioids are widely used to treat pain in trauma patients but being associated with undesirable effects. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement and is safe and easy to perform. Specific populations that have shown benefits (including decreased morbidity and mortality) with regional analgesic techniques include those with fractured ribs and femur and hip fractures and patients undergoing digital replantation. The use of regional anesthesia in patients at risk for compartment syndrome is controversial; although the data is sparse, there is no evidence that peripheral nerve blocks delay the diagnosis. The benefit of regional analgesia is most evident when it is initiated as early as possible. The performance of nerve blocks both in the emergency room and in the field has been shown to provide quality pain relief with an excellent safety profile.
- Published
- 2020
45. Neurointervention in Ophthalmologic Disorders
- Author
-
Nicholas K. Baugnon and Sangeeta Khanna
- Published
- 2022
46. Anaesthetic management of robot-assisted laparoscopic surgery
- Author
-
ChhayaM Suryawanshi, Bhavini Shah, Sangeeta Khanna, Poonam Ghodki, Kanta Bhati, and KV Ashok
- Subjects
Anesthesiology and Pain Medicine - Published
- 2023
47. The Pediatric Optic Neuritis Prospective Outcomes Study: Two-Year Results
- Author
-
Stacy L, Pineles, Robert J, Henderson, Michael X, Repka, Gena, Heidary, Grant T, Liu, Amy T, Waldman, Mark S, Borchert, Sangeeta, Khanna, Jennifer S, Graves, Janine E, Collinge, Julie A, Conley, Patricia L, Davis, Raymond T, Kraker, Susan A, Cotter, Jonathan M, Holmes, and Lawrence, Tychsen
- Subjects
Male ,Multiple Sclerosis ,Optic Neuritis ,Adolescent ,Neuromyelitis Optica ,Vision Disorders ,Child, Preschool ,Humans ,Female ,Myelin-Oligodendrocyte Glycoprotein ,Prospective Studies ,Neoplasm Recurrence, Local ,Child ,Retrospective Studies - Abstract
Pediatric optic neuritis (ON) is a rare disease that has not been well characterized. The Pediatric ON Prospective Outcomes Study (PON1) was the first prospective study to our knowledge aiming to evaluate visual acuity (VA) outcomes, including VA, recurrence risk, and final diagnosis 2 years after enrollment.Nonrandomized observational study at 23 pediatric ophthalmology or neuro-ophthalmology clinics in the United States and Canada.A total of 28 (64%) of 44 children initially enrolled in PON1 (age 3-16 years) who completed their 2-year study visit.Participants were treated at the investigator's discretion.Age-normal monocular high-contrast VA (HCVA). Secondary outcomes included low-contrast VA (LCVA), neuroimaging findings, and final diagnoses.A total of 28 participants completed the 2-year outcome with a median enrollment age of 10.3 years (range, 5-15); 46% were female, and 68% had unilateral ON at presentation. Final 2-year diagnoses included isolated ON (n = 11, 39%), myelin oligodendrocyte glycoprotein-associated demyelination (n = 8, 29%), multiple sclerosis (MS) (n = 4,14%), neuromyelitis optica spectrum disease (NMOSD) (n = 3, 11%), and acute disseminated encephalomyelitis (n = 2, 7%). Two participants (7%; 95% confidence interval [CI], 1-24) had subsequent recurrent ON (plus 1 participant who did not complete the 2-year visit); all had MS. Two other participants (7%) had a new episode in their unaffected eye. Mean presenting HCVA was 0.81 logarithm of the minimum angle of resolution (logMAR) (∼20/125), improving to 0.14 logMAR (∼20/25Despite poor VA at presentation, most children had marked improvement in VA by 6 months that was maintained over 2 years. Associated neurologic autoimmune diagnoses were common. Additional episodes of ON occurred in 5 (18%) of the participants (3 relapses and 2 new episodes).
- Published
- 2021
48. SAFETY OF HYDROXYCHLOROQUINE FOR COVID-19 PROPHYLAXIS AMONG HEALTHCARE WORKERS: AN OBSERVATIONAL STUDY
- Author
-
Amit Arora, Nitul M Bewal, Krishna Prasad G, and Sangeeta Khanna
- Subjects
Pharmacology ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Health care ,medicine ,Pharmaceutical Science ,Pharmacology (medical) ,Observational study ,Hydroxychloroquine ,Intensive care medicine ,business ,medicine.drug - Abstract
Objective: Indian Council of Medical Research recommended hydroxychloroquine (HCQ) for prophylaxis of COVID‐19 for healthcare workers and the Food and Drug Administration approved its use in the treatment and prophylaxis of COVID‐19 disease. Even though HCQ is adequately tolerated in usual circumstances, still questions about the harmful effects of the drug remain a cause for concern in adults treated with HCQ. The objective of this study was to evaluate the major and minor adverse effects of prophylactic HCQ for COVID-19 among healthcare workers. Methods: Our analysis was intended to analyze HCQ’s adverse drug reaction profile for COVID‐19 prophylaxis in prophylactic doses in health-care staff. This was a cross-sectional study carried out among healthcare workers taking HCQ prophylaxis for COVID‑19. The study was carried out over 08 weeks period from April to May 2020. The data were obtained regarding age, sex, comorbidities, and possible adverse effects. A pretested and validated online questionnaire was provided to the participants to assess the harmful effects that they experienced when taking HCQ. Furthermore, pre and post 8 weeks prophylaxis, individuals underwent general and systemic examination, along with ECG and blood sugar level monitoring. Results: The research group comprised 70 previously healthy and health-care staff. In 70 patients, 27 minor adverse effects were reported (18.9%). Headache was the most frequently reported symptoms followed by nausea and vomiting, itching, and skin rashes. There was no statistically relevant variation in harmful effects due to age or number of doses administered. However, none of the adverse effects was serious or debilitating. Conclusion: With adequate pre-prophylaxis evaluation, health education, and regular monitoring, HCQ prophylaxis is safe and devoid of any serious adverse effects in previously healthy individuals.
- Published
- 2020
49. Peripartum amniotic fluid embolism with disseminated intravascular coagulation during ongoing coronavirus disease pandemic – A case report
- Author
-
Sravan Kumar Reddy Kasa, Sangeeta Khanna, Anish Kumar Vishal, G V Krishna Prasad, and Dinesh Bhasin
- Subjects
Disseminated intravascular coagulation ,medicine.medical_specialty ,Respiratory distress ,business.industry ,Obstetrics ,Mortality rate ,Disease ,medicine.disease ,Amniotic fluid embolism ,Case fatality rate ,Pandemic ,Back pain ,Medicine ,medicine.symptom ,business - Abstract
Amniotic fluid embolism (AFE) is a relatively rare but potentially catastrophic obstetric emergency. Early studies revealed mortality rates as high as 61–86%, but more recent estimates suggest a case fatality of 13–26% with adverse neonatal outcomes. The decrease in mortality can be because of the high index of suspicion and aggressive management practices. We report a case of AFE which manifested atypically with severe back pain and respiratory distress in operation theater before anesthesia induction for elective cesarean (lower segment cesarean section).
- Published
- 2020
50. Ectopia lentis in <scp>Loeys‐Dietz</scp> syndrome type 4
- Author
-
Alan C. Braverman, Marcia C. Willing, Sangeeta Khanna, and Kevin J. Blinder
- Subjects
0301 basic medicine ,Marfan syndrome ,Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Disease ,030105 genetics & heredity ,medicine.disease ,Loeys–Dietz syndrome ,Familial thoracic aortic aneurysm ,03 medical and health sciences ,030104 developmental biology ,Genetics ,Medicine ,Craniofacial ,business ,Ectopia lentis ,Genetics (clinical) ,Exome sequencing ,Genetic testing - Abstract
Loeys-Dietz syndrome is a heritable disorder of the connective tissue leading to multisystem involvement including craniofacial features, skeletal abnormalities, cutaneous findings and early-onset and aggressive disease of the aorta and its branches. There are multiple types of Loeys-Dietz syndrome related to pathogenic variants in TGFBR1, TGFBR2, SMAD3, TGFB2, and TGFB3. Individuals with Loeys-Dietz syndrome may be misdiagnosed as having Marfan syndrome due to shared phenotypic features and aortic root dilation. However, ectopia lentis has been an important discriminating feature, being unique to Marfan syndrome and not reported to be associated with Loeys-Dietz syndrome. We report the case of a 46-year-old woman with Loeys-Dietz syndrome type 4 due to a pathogenic variant in TGFB2 who was diagnosed with ectopia lentis at age 44. The patient underwent whole exome sequencing and no other pathogenic variants were found to explain the ectopia lentis. Our findings indicate that ectopia lentis may be an uncommon finding in Loeys-Dietz syndrome type 4 and emphasize the importance of genetic testing in familial thoracic aortic aneurysm disease.
- Published
- 2020
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