1.Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: A real world experience from a regional cancer center
Sushma AGRAWAL ; Rahul ; Mohammed Naved ALAM ; Neeraj RASTOGI ; Ashish SINGH ; Rajneesh Kumar SINGH ; Anu BEHARI ; Prabhakar MISHRA
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(1):38-47
Background:
s/Aims: Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.
Methods:
This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis.
Results:
The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (p = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (p > 0.05).
Conclusions
Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.
2.Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: A real world experience from a regional cancer center
Sushma AGRAWAL ; Rahul ; Mohammed Naved ALAM ; Neeraj RASTOGI ; Ashish SINGH ; Rajneesh Kumar SINGH ; Anu BEHARI ; Prabhakar MISHRA
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(1):38-47
Background:
s/Aims: Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.
Methods:
This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis.
Results:
The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (p = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (p > 0.05).
Conclusions
Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.
3.Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: A real world experience from a regional cancer center
Sushma AGRAWAL ; Rahul ; Mohammed Naved ALAM ; Neeraj RASTOGI ; Ashish SINGH ; Rajneesh Kumar SINGH ; Anu BEHARI ; Prabhakar MISHRA
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(1):38-47
Background:
s/Aims: Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.
Methods:
This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis.
Results:
The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (p = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (p > 0.05).
Conclusions
Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.
4.Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing:A split-mouth randomized controlled trial
Subrat Kumar SATAPATHY ; Surya Kanta DAS ; Ashish Kumar BARIK ; Devpartim MOHANTY ; Sunil Kumar RATH ; Mitali MISHRA
The Korean Journal of Orthodontics 2024;54(5):303-315
Objective:
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods:
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results:
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.
5.Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing:A split-mouth randomized controlled trial
Subrat Kumar SATAPATHY ; Surya Kanta DAS ; Ashish Kumar BARIK ; Devpartim MOHANTY ; Sunil Kumar RATH ; Mitali MISHRA
The Korean Journal of Orthodontics 2024;54(5):303-315
Objective:
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods:
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results:
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.
6.Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing:A split-mouth randomized controlled trial
Subrat Kumar SATAPATHY ; Surya Kanta DAS ; Ashish Kumar BARIK ; Devpartim MOHANTY ; Sunil Kumar RATH ; Mitali MISHRA
The Korean Journal of Orthodontics 2024;54(5):303-315
Objective:
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods:
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results:
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.
7.Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing:A split-mouth randomized controlled trial
Subrat Kumar SATAPATHY ; Surya Kanta DAS ; Ashish Kumar BARIK ; Devpartim MOHANTY ; Sunil Kumar RATH ; Mitali MISHRA
The Korean Journal of Orthodontics 2024;54(5):303-315
Objective:
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods:
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results:
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.
8.Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing:A split-mouth randomized controlled trial
Subrat Kumar SATAPATHY ; Surya Kanta DAS ; Ashish Kumar BARIK ; Devpartim MOHANTY ; Sunil Kumar RATH ; Mitali MISHRA
The Korean Journal of Orthodontics 2024;54(5):303-315
Objective:
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods:
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results:
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.
9.Assessment of Knowledge, Attitudes, and Practices of Parents/Caregivers Towards Migraine in Children: A Cross-Sectional Observational Study
Rahul SINHA ; Ankit Kumar MEENA ; Maneesh UNIYAL ; Sonali SINGH ; Ashish UPADHYAY
Annals of Child Neurology 2024;32(1):8-12
Purpose:
This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of parents or caregivers of children suffering from migraines at a tertiary care center in North India.
Methods:
We conducted a cross-sectional study involving 100 parents or caregivers, using convenience sampling. A 20-item questionnaire was administered in English and also translated into the local language (Hindi). The study included children with migraines who visited the pediatric outpatient department within a 6-month period (December 2022 to May 2023).
Results:
Over 60% of caregivers were aware of the chronic nature of the illness, its triggering factors, the role of family history, and the importance of lifestyle modifications. However, only 46% understood the pathophysiology of the illness, and 53% were aware of the medication used for childhood migraines. More than 85% of caregivers believed that recurrent headaches necessitate a doctor’s consultation, may require regular visits for optimal treatment, and were willing to alter their child’s lifestyle to prevent headaches. However, a significant percentage of caregivers (47%) practised self-medication for their children’s headaches. Most caregivers believed that lifestyle modifications and avoiding triggers were the best treatments for migraines. There were significant associations (P<0.05) between the level of education and responses to questions related to migraine definition, prophylaxis, treatment, investigations, lifestyle modifications, and screen time.
Conclusion
Most participants were well-educated on migraine, and their KAP regarding migraine prevention and treatment were generally adequate. However, the practice of self-medication without professional guidance is a significant concern.
10.Laparoscopic Witzel feeding jejunostomy: a procedure overlooked!
Peeyush VARSHNEY ; Vignesh N ; Vaibhav Kumar VARSHNEY ; Subhash SONI ; Selvakumar B ; Lokesh AGARWAL ; Ashish SWAMI
Journal of Minimally Invasive Surgery 2023;26(1):28-34
Purpose:
Feeding jejunostomy (FJ) is a critical procedure to establish a source of enteral nutrition for upper gastrointestinal disorders. Minimally invasive surgery has the inherent benefit of better patient outcomes, less postoperative pain, and early discharge. This study aims to describe our total laparoscopic technique of Witzel FJ and to compare its outcome with its open counterpart.
Methods:
A retrospective database analysis was performed in patients who underwent laparoscopic (n = 20) and open (n = 21) FJ as a stand-alone procedure from July 2018 to July 2022. A readily available nasogastric tube (Ryles tube) and routine laparoscopic instruments were used to perform laparoscopic FJ. Perioperative data and postoperative outcomes were analyzed.
Results:
Baseline preoperative variables were comparable in both groups. The median operative duration in the laparoscopic FJ group was 180 minutes vs. 60 minutes in the open FJ group (p = 0.01). Postoperative length of hospital stay was 3 days vs. 4 days in the laparoscopic and open FJ groups, respectively (p = 0.08). Four patients in the open FJ group suffered from an immediate postoperative complication (none in the laparoscopic FJ group). After a median follow-up of 10 months, fewer patients in the laparoscopic FJ group had complications such as tube clogging, tube dislodgement, surgical-site infection, and small bowel obstruction.
Conclusion
Laparoscopic FJ with the Witzel technique is a safe and feasible procedure with a comparable outcome to the open technique. Patient selection is vital to overcome the initial learning curve.

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