1.Spontaneous Resolution of Emphysematous Gastritis with Vaso-occlusive Disease–A Case Report
Rajesh Nair ; Saurabh Aagrawal ; Bhavna Nayal
Malaysian Journal of Medical Sciences 2013;20(3):68-70
Emphysematous gastritis secondary to vaso-occlusive disease is a surgical emergency. It is a rare yet severe form of widespread phlegmonous gastritis. It is caused by corrosive ingestion, alcohol abuse, and on rare occasions, infections. The clinical presentation is diagnostic with supportive information from contrast-enhanced computed tomography (CECT) of the abdomen and gastroduodenoscopy. Here, we describe a case of emphysematous gastritis with spontaneous vaso-occlusive disease that was successfully managed without surgery.
Hepatic Insufficiency
2.Case of Benign Phyllodes Tumour Associated with Hypoglycemia
Saurabh Agrawal ; Rajesh Nair ; Bharath Malali ; Bhavna Nayal
Malaysian Journal of Medical Sciences 2013;20(2):67-69
Benign phyllodes tumour is a rare non-cancerous growth of the breast characterized by a solitary unilateral tumour in one breast, or rarely multifocal in one or both breasts. It is diagnosed on the basis of physical examination, imaging studies, and fine-needle aspiration cytology. In this report, we present a case of benign phyllodes tumour with an unusual presentation of recurrent attacks of hypoglycemia, which can be attributed to secretion of insulin-like growth factor II from the tumour.
3.Malignant Arrhythmia with Benign Tumour: Fibrolipoma of the Left Ventricle.
Chakanalil Govindan SAJEEV ; Sajeer KALATHINGATHODIKA ; Anishkumar NAIR ; Kader MUNEER ; Gopalan Nair RAJESH ; Vinayakumar DESHABANDHU ; Gomathy SUBRAMANIAM ; Rajesh Sadanandan PILLAI ; Kudakkachira Mathew KURIAKOSE ; Mangalath Narayanan KRISHNAN
Journal of Cardiovascular Ultrasound 2014;22(3):151-154
We report a case of young male referred for evaluation of recent onset recurrent syncope. Inhospital electrocardiogram revealed an episode of ventricular flutter which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram showed hyperechoic mass in the left ventricle. For further tissue characterization a cardiac magnetic resonance imaging was done which revealed a left ventricular mass with predominant fat content. The tumor was surgically resected. Histopathological examination confirmed the diagnosis of cardiac fibrolipoma. The patient recovered and is currently asymptomatic.
Arrhythmias, Cardiac*
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Diagnosis
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Electrocardiography
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Heart Neoplasms
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Heart Ventricles*
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Humans
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Magnetic Resonance Imaging
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Male
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Syncope
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Ventricular Flutter
4.Dynamic smile reanimation in facial nerve palsy
Krishnakumar Krishnan SANTHA ; Subin JOSEPH ; Sameer LATHEEF ; Saju NARAYANAN ; Santhy Mohanachandran NAIR ; Bibilash BABU ; Anand SIVADASAN ; Srivatsa Manjunath SHET ; Rajesh Vardhan PYDI ; Ajit PATI ; Srikant Aruna SAMANTARAY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2020;46(2):143-149
Objectives:
Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures.
Materials and Methods:
In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures.
Results:
Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001).
Conclusion
Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.
5.Prospective evaluation of fiducial marker placement quality and toxicity in liver CyberKnife stereotactic body radiotherapy
Debnarayan DUTTA ; Kaushik Jagannath KATAKI ; Shibu GEORGE ; Sruthi K. REDDY ; Ajay SASHIDHARAN ; Rajesh KANNAN ; Ram MADHAVAN ; Haridas NAIR ; Tushar TATINENI ; Raghavendra HOLLA
Radiation Oncology Journal 2020;38(4):253-261
Background:
Evaluate morbidities and “quality” of fiducial marker placement in primary liver tumours (hepatocellular carcinoma [HCC]) for CyberKnife.
Materials and Methods:
Thirty-six HCC with portal vein thrombosis(PVT) were evaluated for “quality” of fiducial placement, placement time, pain score, complications, recovery time and factors influencing placement.
Results:
One hundred eight fiducials were placed in 36 patients. Fiducial placement radiation oncologist score was “good” in 24(67%), “fair” in 4(11%), and “poor” in 3(8%) patients. Concordance with radiologist score in “poor”, “fair”, and “good” score was 2/2(100%), 4/5(80%), and 24/27(89%), respectively(p=0.001). Child-Pugh score(p=0.080), performance status(PS) (p=0.014) and accrued during “learning curve”(p=0.013) affected placement score. Mean placement time(p=0.055), recovery time(p=0.025) was longer and higher major complications(p=0.009) with poor PS. Liver segment involved(p=0.484) and the Barcelona Clinic Liver Cancer(BCLC) stage did not influence placement score. “Good” placement score was 30% in first cohort whereas 93% in last cohort(p=0.023). Time for placement was 42.2 and 14.3 minutes, respectively(p=0.069). Post-fiducial pain score 0–1 in 26 patients(72%) and pain score 3–4 was in 2(6%). Five patients (14%) admitted in “day-care”(2 mild pneumothorax, 3 pain). Mortality in 1 patient(3%) admitted for hemothorax.
Conclusion
Fiducial placement is safe and in experienced hands, “quality” of placement is “good” in majority. Major complications and admission after fiducial placement are rare. Complications, fiducial placement time, recovery time is more during the “learning curve”. Poor Child-Pugh score, extensive liver involvement, poor PS have higher probability of complications.
6.Prospective evaluation of fiducial marker placement quality and toxicity in liver CyberKnife stereotactic body radiotherapy
Debnarayan DUTTA ; Kaushik Jagannath KATAKI ; Shibu GEORGE ; Sruthi K. REDDY ; Ajay SASHIDHARAN ; Rajesh KANNAN ; Ram MADHAVAN ; Haridas NAIR ; Tushar TATINENI ; Raghavendra HOLLA
Radiation Oncology Journal 2020;38(4):253-261
Background:
Evaluate morbidities and “quality” of fiducial marker placement in primary liver tumours (hepatocellular carcinoma [HCC]) for CyberKnife.
Materials and Methods:
Thirty-six HCC with portal vein thrombosis(PVT) were evaluated for “quality” of fiducial placement, placement time, pain score, complications, recovery time and factors influencing placement.
Results:
One hundred eight fiducials were placed in 36 patients. Fiducial placement radiation oncologist score was “good” in 24(67%), “fair” in 4(11%), and “poor” in 3(8%) patients. Concordance with radiologist score in “poor”, “fair”, and “good” score was 2/2(100%), 4/5(80%), and 24/27(89%), respectively(p=0.001). Child-Pugh score(p=0.080), performance status(PS) (p=0.014) and accrued during “learning curve”(p=0.013) affected placement score. Mean placement time(p=0.055), recovery time(p=0.025) was longer and higher major complications(p=0.009) with poor PS. Liver segment involved(p=0.484) and the Barcelona Clinic Liver Cancer(BCLC) stage did not influence placement score. “Good” placement score was 30% in first cohort whereas 93% in last cohort(p=0.023). Time for placement was 42.2 and 14.3 minutes, respectively(p=0.069). Post-fiducial pain score 0–1 in 26 patients(72%) and pain score 3–4 was in 2(6%). Five patients (14%) admitted in “day-care”(2 mild pneumothorax, 3 pain). Mortality in 1 patient(3%) admitted for hemothorax.
Conclusion
Fiducial placement is safe and in experienced hands, “quality” of placement is “good” in majority. Major complications and admission after fiducial placement are rare. Complications, fiducial placement time, recovery time is more during the “learning curve”. Poor Child-Pugh score, extensive liver involvement, poor PS have higher probability of complications.