Anjay Kumar

Bihar Agricultural University

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Pankaj Kumar Garg

National Institute of Pharmaceutical Education and Research

Debajyoti Mohanty

All India Institute of Medical Sciences Raipur

AshwaniKumar Dalal

All India Institute of Medical Sciences Raipur

Ashwani Kumar Dalal

Government Medical College and Hospital

Mritunjay Sarawagi

Rajendra Institute of Medical Sciences

ГМ

Г.К. Мухамеджанов

ДИ

Д.Т. Ирискулова

Manjit Singh

Punjabi University

Ruchir Singh

University of Birmingham

Bhupendra Kumar Jain

University College of Medical Sciences

Cooperative Institutions

University of Delhi

University College of Medical Sciences

Guru Teg Bahadur Hospital

Rajendra Institute of Medical Sciences

National Institute of High Security Animal Diseases

Institute of Medical Sciences

All India Institute of Medical Sciences

All India Institute of Medical Sciences Raipur

Indian Veterinary Research Institute

Kerala Veterinary and Animal Sciences University

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Unusual cause of rectal bleeding

Saudi Journal of Gastroenterology (2011)

Pankaj Kumar Garg Anjay Kumar

A 19-year-old young man presented with multiple episodes of rectal bleeding of 2 years duration. On physical examination, he had severe pallor and an asymmetric, edematous hypertrophy of left lower limb with multiple dilated and tortuous veins present along the posterolateral aspect [Figure 1]. Laboratory evaluation demonstrated significant anemia with hemoglobin of 6.9 g/dL and hematocrit of 20.9%. Diagnostic colonoscopy demonstrated venous ectasia extending from the dentate line to descending colon [Figure 2]. No active bleeding was noted. Esophago-gastroduodenoscopy was unremarkable.Figure 1: Clinical photograph showing asymmetric, edematous hypertrophy of left lower limbFigure 2: Colonoscopy showing multiple venous ectasia in rectumQUESTION Q1. What is the diagnosis? ANSWER The clinical picture is consistent with the diagnosis of Klippel–Trenaunay Syndrome (KTS). Noted French physicians Maurice Klippel and Paul Trenaunay described this syndrome in 1900 which is characterized by a triad of vascular malformations, venous varicosity and bony and/or soft tissue hypertrophy.[1] Visceral vascular malformations are uncommon in KTS but may cause significant morbidity and mortality.[2] Gastrointestinal malformations are more common than those of genitourinary tract. Bleeding is the most common manifestation of intestinal vascular malformations and may prove to be a potentially life-threatening emergency. Platelet sequestration with secondary consumption of clotting factors within the venous sinusoids of the visceral vascular malformations may further enhance bleeding (Kasabach–Merritt phenomenon).[3]

Ectasia

Pallor

Klippel-Trenaunay Syndrome

Venous malformation

Melena

10.4103/1319-3767.87187

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Abdominal and pelvic injury in poly trauma patient: A general surgeon′s perspective

Journal of Orthopedics Traumatology and Rehabilitation (2013)

Debajyoti Mohanty Anjay Kumar AshwaniKumar Dalal

In this era of modern mechanization of the world, the incidence of poly trauma is increasing every day. Abdominal and pelvic trauma resulting in concealed hemorrhage is the main cause of mortality following poly trauma. Most of these deaths can be prevented by early diagnosis and prompt management of the underlying cause of hemorrhage. Identification of the victims with persistent hemodynamic abnormality in need of early surgical intervention is essential for a better patient outcome. Focused assessment with sonography in trauma is a useful bedside tool that aid in early identification of patients with intra-abdominal hemorrhage. Computed tomogram of the abdomen is the preferred diagnostic modality in the management of hemodynamic normal patients. Damage control surgery is beneficial in the subset of patients with depleted physiologic reserve and hemodynamic abnormality

Abnormality

Damage Control Surgery

Damage control

10.4103/0975-7341.118736

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Study Methodology: Crux of a Research Article

Indian Journal of Surgery (2013)

Debajyoti Mohanty Anjay Kumar Ashwani Kumar Dalal

Cardiothoracic surgery

10.1007/s12262-013-1011-4

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Gastric Perforation Due to Intercostal Drainage: Is it a Clue to Missed Diaphragmatic Hernia?

Asian Journal of Case Reports in Surgery (2021)

Abhishek Kushwaha Anjay Kumar Shadab Hasan

Perforation

Source

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Pseudotumor of urinary bladder by infected hernia mesh: Where is the evidence of infection?

Indian Journal of Urology (2014)

Debajyoti Mohanty Anjay Kumar AshwaniKumar Dalal

10.4103/0970-1591.126921

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Ideal Technique of Incisional Hernia Repair: The Quest Continues

Indian Journal of Surgery (2013)

Debajyoti Mohanty Anjay Kumar Ashwani Kumar Dalal

Cardiothoracic surgery

Incisional Hernia

10.1007/s12262-013-1000-7

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Acute abdomen with jaundice: A clue to extrahepatic biliary tract perforation

International Journal of Surgery Case Reports (2022)

Anjay Kumar Shalini Sonali Santosh Kumar Mritunjay Sarawgi

Among a plethora of causes of acute abdomen, spontaneous common bile duct perforation (SCBDP) resulting in biliary peritonitis is almost never envisaged. Since the term SCBDP is often misconstrued as absence of an identifiable cause of perforation, 'nontraumatic perforation of CBD' is also in parlance to exclude relatively common causes such as trauma and iatrogenic injuries. In adults, choledochal cyst, cholangitis, infection, pancreatitis, pancreatobiliary maljunction have been identified as causes of perforation, however, choledocholithiasis remains the most common cause associated with spontaneous perforation of extra hepatic bile duct.Here we present three cases of a spontaneous common bile duct perforation that presented as acute abdomen with peritonitis. Clinical presentation, biochemical abnormalities, imaging details, treatment options, and outcome were studied. This study has been reported in line with the SCARE 2020 Guideline [1].Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gallstones in adults and needs a high index of suspicion during day-to-day practice. Surgeons should seek out this uncommon diagnosis in the patient for early surgical intervention and appropriate drainage to ensure survival.

Acute abdomen

Perforation

Choledochal Cysts

10.1016/j.ijscr.2022.107127

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Citations (1)

Evaluation of different transport media for survival of H5N1 highly pathogenic avian influenza virus.

Research Square (Research Square) (2024)

Baleshwari Dixit H. V. Murugkar S. Nagarajan Manu Dixit Arpita Shrivastav

Abstract In the case of the H5N1 avian influenza outbreak, specific detection is critical for the timely implementation of control and preventive measures to limit the spread of the disease. Sample collection, storage, and transportation are critical for the accurate detection of the virus as its isolation and identification can only be done in a designated laboratory. In this study, we have compared 5 transport media out of which three are laboratory-based media named Phosphate-buffered Saline (PBS), 50% Glycerol + PBS, and Normal Saline (NS) and two are commercially available media including Viral Transport Medium (VTM), Charcoal based Viral Transport Medium (CVTM) to assess their effect on the survivability of virus in fecal swabs kept under field simulation conditions. Swabs from fecal samples spiked with known 50% embryo infectious dose (EID 50 ) H5N1 virus were collected in each of these transport media, sealed, and stored with ice packs in thermocol boxes similar to the field samples that are being sent to the laboratory. Detection of the virus was done by isolation and reverse transcription-PCR. The results of our study suggested that the most effective transport media for H5N1 avian influenza virus was NS, PBS, and CVTM as the virus could be isolated for up to six days in comparison to VTM and PBS + 50% Glycerol.

Highly pathogenic

H5N1 genetic structure

10.21203/rs.3.rs-3908312/v1

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Citations (1)

Patient satisfaction survey: Can nonresponders be ignored?

North American Journal of Medical Sciences (2012)

Pankaj Kumar Garg Anjay Kumar

Dear Editor, We read the article titled “High satisfaction rating by users of private-for-profit healthcare providers-evidence from a cross-sectional survey among inpatients of a private tertiary level hospital of North India” by Kumar et al.[1] with interest. This article is a testimony to the fact that patient satisfaction with the healthcare services can no longer be ignored even in developing countries. However, the participant selection bias is an important limiting factor while evaluating the patient satisfaction surveys. Kumar et al.[1] did not mention how many patients were approached to participate in the survey and how many of them declined to do so. Gayet-Ageron et al.[2] identified a number of barriers for nonparticipation including language barrier, substance abuse, cognitive limitations, a psychiatric diagnosis and a sight deficiency. We believe that a patient not willing to participate in the survey may have many other reasons also to do so. The nonresponder patient is likely to be the most dissatisfied patient with the present healthcare facility and may be in a haste to search for a better one. His anger and discontent may also be a barrier to his participation in a survey. Although a physically frail patient at discharge is unlikely to participate in the survey, yet he may be the best person to judge the healthcare facilities provided to him. We believe had authors[1] provided the list of diseases that the patients in their survey were treated for; it would have provided a greater insight into the reasons for the level of satisfaction that is projected. In addition, with the longer length of stay, the associated invasiveness of the investigations, the rising cost, the understanding of the disease process by the patient and their relatives, the level of satisfaction may vary. The handling of these patients may provide a better assessment in the overall satisfaction in the care that is offered to them. To conclude, inclusion of patients who declined to participate in the survey coupled with the nature of the diseases that were treated for would result in a more comprehensive assessment of the care that is provided and the degree of content a patient has.

10.4103/1947-2714.104327

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CECAL VOLVULUS

Global Journal For Research Analysis (2022)

Raghib Hassan Mansi Sarawgi Anjay Kumar

Aim- Introduction- To study a case report of caecal volvulus; a rare clinical entity Cecal volvulus is an uncommon cause of intestinal obstruction, and is the axial twisting of the cecum, ascending colon, terminal ileum, and their associated mesenteries as pedicles. It is estimated that it occurs in 2.8–7.1 per million people per year. It is an infrequent cause of intestinal obstruction, accounting for 1−5% of all adult intestinal obstructions; and up to 40% of colonic volvulus. A mobile/non-xed cecum is mentioned as one signicant associated nding in patients with cecal volvulus, and this was seen in about 25% of cadaveric studies.4 Its variable clinical symptoms make it difcult to diagnose early. Case Summary- A 51 years old male presented with features of intestinal obstruction with a history of eight days. X-ray showed features intestinal obstruction with, dilated large bowel loops could be seen with atypical air uid level. A large caecal volvulus was seen with gangrenous caecum and proximal 4 cm of ascending colon. Rest of small bowel was dilated and DJ junction was found on the right of aorta. Resection of cecal volvulus with ileo-ascending anastomoses with proximal loop ileostomy was done. Caecal volvulus is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile c Conclusion- aecum, an embryologic abnormality. Early diagnosis can be difcult due to its unspecic symptoms of small bowel obstruction. The main course of treatment is surgical, and modalities depend on various factors such as patient status and perioperative ndings.

Cecum

Ascending colon

10.36106/gjra/6701829

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