IMSEAR Repository :: Browsing by Author "Gupta, Manoj"

Browsing by Author "Gupta, Manoj"

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Abdominal packing for surgically uncontrollable haemorrhage.
(2010-01) Gupta, Manoj; Nimbalkar, Sangeeta; Singla, Punit; Kumaran, Vinay; Mohanka, Ravi; Mehta, Naimish; Saluja, Satish; Soin, A S; Nundy, S
Background: Using abdominal packs is often a life-saving technique for uncontrollable bleeding during operations. It prevents worsening of the hypothermia, coagulopathy and acidosis which usually accompanies massive bleeding till they may be corrected and the packs removed later. However, packing may be associated with a mortality of 56 to 82 % due to continued bleeding, intra-abdominal abscesses and the compartment syndrome. We follow a policy of early abdominal packing (considering it after a 6 unit intraoperative blood loss) before the situation becomes irreversible. Patients and methods: Between January 1997 and September 2008, abdominal packing for uncontrollable bleed was done in 49 patients (M:F 34:15, mean age 43 years) . The risk factors for mortality were analyzed. The reasons for uncontrollable bleed were : liver trauma (8), liver tumours (3), following liver transplantation (4), pancreatic necrosectomy (17) and miscellaneous causes (17). Results: There were 16 postoperative deaths (32.7%). On univariate analysis, hypovolaemic shock, a low urine output, raised INR, blood requirement of more than 6 units, hypothermia <340C, metabolic acidosis and sepsis were associated with an increased mortality. However, on multivariate logistic regression only hypothermia was significantly associated with mortality. Conclusion: A fair survival rate can be achieved by early and judicious use of abdominal packing especially before hypothermia supervenes.
Adopting the New Normal in Postgraduate Course Summative Assessment for evaluating Clinical Skills: An Experience from India During COVID-19 Pandemic Nation-Wide Lockdown
(Association of Physicians of India, 2022-03) Kathrotia, Rajesh; Dhamija, Puneet; Naithani, Manisha; Kumar, Hemanth; Varghese, Arun; Bahadur, Anupama; Huda, Farhanul; Gupta, Manoj; Kant, Ravi; Patil, Prashant; Rao, Shalinee
An advisory by the association of radiation oncologists of India for radiation therapy patients and staff among COVID 19 pandemic
(Wolters Kluwer India Pvt. Ltd., 2020-07) Talapatra, Kaustav; Gupta, Manoj; Singh, Kishore; Giri, GV; Vashistha, Rajesh
Covid19 has become a major public health problem in India and the rest of the world. The dramatic rise in the incidence of COVID 19 cases has severely challenged our healthcare system and forced us to work with limited infrastructure, resources, and workforce. However, even in this time of adversity, we as oncologists cannot neglect the seriousness of cancer care and the utmost attention it requires for the timely management of our patients. Hence, the Association of Radiation Oncologists of India has come up with an advisory for radiation therapy keeping in mind such aspects.
Computerized tomography based evaluation of level I and II axillary lymph nodes by high conventional tangential fields in carcinoma breast
(Medip Academy, 2020-02) Chandrakant, Lalit; Thakur, Shabnum; Gupta, Manoj; Seam, Rajeev K.; Gupta, Manish; Sharma, Sanjeev
Background: Axillary radiation and surgery have provided equivalent local control in early breast cancer patients. It is believed that tangential field (TF) radiation that was used to treat the breast coincidently delivered radiation treatment to the lower axilla and eradicated the disease. In the era of CT-based three dimensional- (3D) radiotherapy planning, however concerns have been raised about the adequacy of coverage of the axillary levels in the tangential fields. In this study, author evaluated the coverage of the axillary nodal levels I and II using high conventional tangential fields in patients with or without axillary dissection.Methods: A prospective study was conducted which included 18 cases for a period of one year, radiation therapy was planned to the chest wall or whole breast by using the high conventional tangential field using 2D radiation portals. Central lung distance (CLD) and the distance of superior border was measured form the head of the humerus and were recorded. CECT chest was done in the same position alike during conventional simulation. All the images were shifted to the treatment planning system. The Contouring of Axillary lymph nodes level I and II was done on Oncentra contouring software.Results: The coverage of the axillary nodes was not related to central lung distance (CLD). However, some with CLD of 1cm had more coverage of the level I nodes than with CLD of 2 cm and the maximum CLD in the field was 2.5 cm. Of the 18 patients in the study, 13 patients had <2 cm distance from the humeral head and all the axillary level II LN covered in the field. Whereas 5 patients having distance >2 cm did not have adequate coverage of level II axillary LN’s.Conclusions: The distance of the cranial border of the tangent portal from the head of the humerus shows a relationship with coverage of level II nodes cranially. As the distance decreases the coverage of level II nodes cranially keeps increasing. In majority of the patients a distance of 2 cm or less than 2 cm ensured good coverage of level II nodes cranially. Similarly, no correlation was found between volumetric coverage of the axillary nodes with central lung distance.
Concurrent chemoradiation in head and neck cancers with weekly cisplatin: analysing toxicities
(Medip Academy, 2019-12) Vias, Poorva; Gupta, Manoj; Seam, Rajeev Kumar; Gupta, Manish; Fotedar, Vikas; Ahuja, Rachit
Background: Head and neck cancers constitute 6% of cancers worldwide. The management requires a multidisciplinary approach. Concomitant chemoradiotherapy with cisplatin is the standard approach for locally advanced head and neck cancers. The most commonly used regime uses three weekly cisplatin which is more toxic. Low-dose once-a-week cisplatin is substituted because of perceived lower toxicity and convenience. Methods: Squamous cell carcinoma of stage III, IVA and IVB of oropharynx, hypopharynx and larynx were studied for one year. 82 patients were studied. Total dose of radiation was 66Gy/33#/6 ½ weeks from Monday to Friday with inj. Cisplatin 40mg/m2 i.v. infusion weekly.Results: 88% of patients were able to complete five or more weekly chemotherapy cycles with cumulative dose of 200mg/m2. Grade 2 and 3 acute toxicities were seen in weekly cisplatin arm but were conservatively managed.Conclusions: Weekly cisplatin can be used with concurrent radiotherapy as the acute toxicities are manageable and is well tolerated.
Effect Of High Myopia On The Visual Outcome Following Cataract Surgery
(Indian Society for Health and Advanced Research, 2024-06) Irshad, Summaiya; Gupta, Manoj; Samuel, Ruchi Singh
Visual impairment, or blindness, is a serious global health concern. The degenerative condition known as cataract causes the lens's proteins to break down, opacifying the lens. Lenses and glasses are used to cure early cataracts and refractive problems, whilst surgical procedures are necessary for moderate to advanced cataracts. The procedure of cataract surgery is both cost-effective and safe. Cataract is the most prevalent associated complication of high myopia, and around 30% cataract surgeries include severely myopic patients.The present observational study was conducted to evaluate the effect of high myopia on the visual outcome following cataract surgery among 103 eyes with cataract and high myopia. It was found that the age range of 28� years accounted for the bulk of the patients (40.77%) and the male to female ratio was 1.57:1. Mostly (69.9%) right eye was involved and nuclear cataract was the most common (36.89%) type of cataract. There was improvement in post-operative visual acuity, mean spherical equivalent, mean best corrective visual acuity, mean anterior chamber angle and mean CCT as compared to the pre-operative ?ndings. The depth of anterior chamber was found to decrease after surgery and intraocular pressure also improved post-operatively. The present study concluded that cataract surgery was the better technique to improve the visual acuity among patients with high myopia. In the present study good post-operative outcome was observed in patients with cataract and high myopia.
Extranodal follicular dendritic cell sarcoma presenting as colonic mass: A diagnostic and therapeutic challenge
(Wolters Kluwer - Medknow, 2024-01) Pasricha, Sunil; Durga, Garima; Sharma, Anila; Jajodia, Ankush; Singh, Shivendra; Gupta, Gurudutt; Kamboj, Meenakshi; Koyyala, Venkata Pradeep Babu; Gupta, Manoj; Mehta, Anurag
Folliclular dendritic cell sarcoma (FDCS) is an extremely rare neoplasm originating from folliclular dendritic cells, both nodally and extranodally. Its primary presentation as a large colonic mass is rare and can be misdiagnosed as epithelial tumor/soft tissue tumor both clinically and through histomorphology. Due to its rarity and limited consensus guidelines about its management, it presents as a diagnostic and therapeutic challenge for pathologists and oncologists. However, accurate diagnosis is imperative due to its distinct prognostic and therapeutic implications. Herein we report, two cases of extranodal FDCS of colon with the aim of contributing to the management of this uncommon entity.
Four percent formalin application for the management of radiation proctitis in carcinoma cervix patients: An effective, safe, and economical practice
(Wolters Kluwer India Pvt. Ltd., 2019-01) Sharma, Brij; Gupta, Manish; Sharma, Rajesh; Gupta, Ankur; Sharma, Neetu; Sharma, Mukesh; Sharma, Vineeta; Siddharth Vats; Gupta, Manoj; Seam, Rajeev Kumar
Context: Radiotherapy is a very effective treatment modality for pelvic malignancies such as carcinoma of the cervix. However, it is quite common for chronic radiation proctitis (CRP) to manifest after radical radiotherapy. CRP is a source of significant morbidity, and there is a lack of effective treatment modalities. There also exists a general lack of guidelines on management of CRP. Aims: To assess the benefit from 4% formalin application for the treatment of Grade >2 CRP among patients previously treated with radical radiotherapy for cervical carcinoma. Settings and Design: This retrospective descriptive study involved 29 eligible patients who were treated from November 2010 - November 2015 for CRP with 4% formalin application. Materials and Methods: Of the 1864 patients of carcinoma cervix treated during the said patients, 29 patients fulfilled the eligibility criteria. Eligible patients were invited telephonically for follow-up and were assessed for response and complications of the procedure. Results: The treatment of hemorrhagic radiation proctitis with local formalin instillation is effective, well tolerated and safe procedure. The procedure is inexpensive, technically simple and can be done on an outpatient basis. 62% patients had complete freedom from rectal bleed, while 34.5% patients had partial benefit. Only one patient required diversion colostomy for persistent bleeding.
Huge uterine-cervical diverticulum mimicking as a cyst.
(2012-07) Chufal, S; Thapliyal, Naveen; Gupta, Manoj; Pangtey, Nirmal
Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.
Retinoblastoma: A Curse to Childhood.
(2013-07) Jhagta, Harpal Singh; Jain, Prachi; Gupta, Manoj; Bajaj, Ashish
Retinoblastoma is the most common intraocular malignancy in children. With the improvement in diagnostic and treatment modalities, early diagnosis and prompt treatment have remarkably improved the survival and salvageable vision in retinoblastoma patients. We report a case of a 14-month-old female child who presented to us with intermittent deviation of both eyes and white reflex in both eyes along with redness and photophobia in right eye, she was diagnosed to liver bilateral retinoblastoma.
Roux loop obstruction by an enterolith formation around migrated endobiliary stent.
(2011-07) Gupta, Manoj; Mohanka, Ravi; Kumaran, Vinay; Mehta, Naimish N; Rastogi, Amit; Soin, Arvinder S; Nundy, Samiran
Sacrum metastasis in carcinoma gall bladder: an unusual presentation
(Medip Academy, 2020-05) Sajeevan, Sanjay; Das, Biswajyoti; Yanthan, Yanpothung; K., Naseef P.; Gupta, Sweety; Gupta, Amit; Narayan, Manishi L.; Gupta, Manoj
Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually occur late. The most common site of extra-abdominal metastasis is lung followed by brain. Skeletal metastases in carcinoma gall bladder are very rare. To date there have only been a few case reports of bone metastasis in carcinoma gall bladder at the time of presentation. Authors here present a rare case of carcinoma gall bladder that progressed to isolated sacrum metastasis.

Browsing by Author "Gupta, Manoj"

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