Browsing by Author "Malik, A. A."
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Item Outcomes of usage of polypropylene mesh in TAPP hernia repair(Medip Academy, 2023-05) Kumar, A.; Malik, A. A.; singh, G.; Bhat, A.Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair. Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh. Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery. Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.Item Outcomes of usage of polypropylene mesh in TAPP hernia repair(Medip Academy, 2023-05) Kumar, A.; Malik, A. A.; singh, G.; Bhat, A.Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair. Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh. Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery. Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.Item Pilonidal sinus: excision and primary closure over suction drain and its outcome(Medip Academy, 2023-02) Malik, A. A.; Khurshid, S.- ul-.; Muzaffar, R.; Muzzafar, K.Background: Pilonidal sinus is a chronic inflammatory disease predominantly involving Sacrococcygeal region. Despite advances in medical sciences, management of pilonidal disease is still not well defined. Treatment varies from simple techniques to more sophisticated surgeries with their own pros and cons. Methods: This prospective observational study comprised of forty-two patients who underwent the surgery for pilonidal sinus as per the procedure described. This study was carried from 1 May 2019 till 30 November 2022. Median age of the patients was 24.5 years, ranging between 19-32 years. Sinus discharge was the predominant symptom of our study population with 34 patients (80.94%) complaining of same. Results: Mean operative time was 54 minutes with a range of 45-78 minutes. Average hospital stay was 1.8 days though it ranged from 1 to 3 days. Five patients (11.90%) developed seroma while four patients (9.52%) had superficial wound site infection. We had two recurrences (4.76%) over the follow-up period of 1 year. Conclusions: Excision and primary closure of the pilonidal disease is effective with comparable complication rates and shorter time off work. The surgery can be easily performed.Item Prevalence and spectrum of rheumatological diseases in a newly formed Peripheral Medical College in Northern India(Medip Academy, 2023-06) Malik, A. A.; Kelam, M. A.; Sharma, S. K.Background: Rheumatic disorders are chronic inflammatory and non-inflammatory disorders of the musculoskeletal system and connective tissue causing a significant socioeconomic burden resulting in immense morbidity owing to poor quality of life, loss of function and productivity. Methods: In this prospective study, consecutive patients attending Medicine Outpatient Department at GMC Doda, between august 2019 and July 2022, were studied for various rheumatological diseases. Rheumatological diagnoses of 3560 consecutive newly detected and returning patients were recorded for three year. Results: During the study period, a total of 27546 patients visited the Medicine OPD, 3560 of which were diagnosed with various rheumatic diseases, yielding a prevalence of 12.9%. The mean age of the patients in the study was 42.33±13.18 years ranging from a minimum age of 18 to a maximum age of 96 years. Females were notably predominant in all diseases at 64%. Non inflammatory rheumatological disorders osteoarthritis and soft tissue rheumatism were most predominant in this study. Conclusions: Osteoarthritis and soft tissue rheumatism were the most predominant rheumatic disorders in our study. Rheumatic diseases constitute a major disease burden in almost all of the age groups, especially in young patients (30-50 years) within our setup.Item Prevalence and spectrum of rheumatological diseases in a newly formed Peripheral Medical College in Northern India(Medip Academy, 2023-06) Malik, A. A.; Kelam, M. A.; Sharma, S. K.Background: Rheumatic disorders are chronic inflammatory and non-inflammatory disorders of the musculoskeletal system and connective tissue causing a significant socioeconomic burden resulting in immense morbidity owing to poor quality of life, loss of function and productivity. Methods: In this prospective study, consecutive patients attending Medicine Outpatient Department at GMC Doda, between august 2019 and July 2022, were studied for various rheumatological diseases. Rheumatological diagnoses of 3560 consecutive newly detected and returning patients were recorded for three year. Results: During the study period, a total of 27546 patients visited the Medicine OPD, 3560 of which were diagnosed with various rheumatic diseases, yielding a prevalence of 12.9%. The mean age of the patients in the study was 42.33±13.18 years ranging from a minimum age of 18 to a maximum age of 96 years. Females were notably predominant in all diseases at 64%. Non inflammatory rheumatological disorders osteoarthritis and soft tissue rheumatism were most predominant in this study. Conclusions: Osteoarthritis and soft tissue rheumatism were the most predominant rheumatic disorders in our study. Rheumatic diseases constitute a major disease burden in almost all of the age groups, especially in young patients (30-50 years) within our setup.Item Primary hydatid cyst of erector spinae muscle of upper back(Medip Academy, 2024-02) Illahi, M. F.; Gani, M.; Malik, A. A.Hydatid disease is a zoonosis caused by an infection with the larvae of the tapeworm Echinococcus granulosus, it mostly involves liver and lungs but it may exceptionally affect muscle. We report the case of a 29 years old man who was admitted to our surgical clinic with a primary hydatid cyst in erector spinae muscle of upper back diagnosed by clinic examination, imaging and serological testing. The treatment was a complete pericystectomy and chemotherapy by antiparasitic drugs. Hydatid disease is an endemic disease in sheep-producing regions. In human, this disease involves usually the liver and the lungs and exceptionally the muscle. The diagnosis may be challenging, as it should consider arguments such as history, physical examination, imaging and serological testing. The best treatment is pericystectomy with perioperative chemotherapy to reduce risk of occurrence. The hydatid cyst of erector spinae muscle is exceptional even in endemic area, the diagnosis may be challenging and the surgery is the gold standard of treatment.