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Raghuthaman S, Bansal K, Quadri JA, Mathur VP, Tewari N, Morankar R. Salivary and urinary assessment of fluoride and silver ion concentrations after silver diamine fluoride application in children: a prospective cohort study. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00897-4. [PMID: 38635111 DOI: 10.1007/s40368-024-00897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE The purpose of the study was to determine the fluoride (F) and silver (Ag) ions levels in the saliva and urine of healthy children after silver diamine fluoride (SDF) application on dental carious lesions. METHODS Sixty children (4-6 years with ≥ 3 caries lesions) were recruited from the outpatient department of Pediatric Dentistry. From each child, 3 ml unstimulated saliva samples were collected at baseline, one hour, and 24 h after SDF application. Similarly, 3 ml urine samples were collected prior to and after 24 h of SDF application. F and Ag ion concentrations were determined by fluoride ion-selective electrode (ISE) and inductively coupled plasma mass spectrometry (ICPMS), respectively. RESULTS The mean ± standard deviation (SD) baseline, 1-h, and 24-h salivary F concentrations (ppm) were 0.07 ± 0.07, 0.93 ± 0.48, and 0.19 ± 0.19, respectively, while the mean baseline and 24-h urinary F concentrations (ppm) were 0.33 ± 0.20 ppm and 0.43 ± 0.25 ppm, respectively. The mean baseline, 1-h, and 24-h salivary Ag concentrations (ppb) were 4.22 ± 3.15, 4198 ± 350, and 56.93 ± 37, respectively. The mean baseline and 24-h urinary Ag concentrations (ppb) were 2.80 ± 2.93 ppb and 4.72 ± 4.0 ppb, respectively. There were statistically elevated F and Ag ion concentrations at 1 h and 24 h after SDF application as compared to the baseline. CONCLUSION Salivary and urinary F and Ag ions concentrations elevated significantly at 24 h following SDF applications in children. A significant high recovery of these ions in urine indicates minimal systemic absorption, thus intermittent topical application of 38% SDF has a minimal risk of toxicity.
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Affiliation(s)
- S Raghuthaman
- Department of Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - K Bansal
- Department of Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - J A Quadri
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - V P Mathur
- Department of Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - N Tewari
- Department of Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - R Morankar
- Department of Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
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Gupta A, Guha M, Bansal K. A rare case of spontaneous giant pneumorrachis presenting with cauda equina syndrome: a case report. Spinal Cord Ser Cases 2024; 10:18. [PMID: 38589363 PMCID: PMC11001869 DOI: 10.1038/s41394-024-00631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Pneumorrachis is presence of air in the epidural space. It could be the result of trauma, barotrauma, iatrogenic or spontaneous. The pneumorrachis per se is an underdiagnosed entity as most of the patients are asymptomatic or have subclinical symptoms. The spontaneous occurrence of pneumorrachis has been reported in literature but giant spontaneous occurrence causing cauda equina syndrome has not been reported so far. CASE PRESENTATION We report a case of 56-year-old male patient who came to our OPD on wheelchair with complains of difficulty in walking for 6 months with dribbling of urine for 2 months with on and off back pain. His perianal sensation was reduced with absent voluntary anal contraction. Imaging revealed giant air pockets in the spinal canal of L5-S1 extending upto L4-L5. It was managed surgically wherein laminectomy without fusion was done. The patient responded well to the treatment. DISCUSSION There are many causes of pneumorrachis described in literature. Most of the cases of pneumorrachis are asymptomatic and incidentally diagnosed. With the improvement in radio-diagnostic modalities, the diagnosis of pneumorrachis can be easily established. When symptomatic, they can be managed conservatively. Those presenting with neurological deficit may require surgical intervention or other invasive intervention.
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Affiliation(s)
- Anuj Gupta
- Spine Surgery, Max Super Speciality Hospital, Vaishali, New Delhi, India
| | - Mayukh Guha
- Fellow of National Board, Spine Surgery, Indian Spinal Injuries Centre, New Delhi, India
| | - Kuldeep Bansal
- Spine Surgery, Indian Spinal Injuries Centre, New Delhi, India.
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Sareen A, Guha M, Bansal K, Hegde A, Boruah T. Single Sequence Whole-Spine Screening Magnetic Resonance Imaging: Diagnostic and Therapeutic Role in Multiple-Level Spinal Tuberculosis. Cureus 2024; 16:e52757. [PMID: 38389615 PMCID: PMC10882150 DOI: 10.7759/cureus.52757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Spinal tuberculosis (TB) is the most common form of skeletal tuberculosis. Paradiscal continuous vertebral involvement at a single level is the most prevalent pattern among all forms of spinal TB. There is a wide range of reported incidences of multiple-level non-contiguous spinal TB in the literature. We would like to discuss on the utility of single whole spine screening T2-weighted (T2W) mid-sagittal magnetic resonance imaging (MRI) film in diagnosing multiple-level spinal TB and therapeutic benefits it can provide. METHODS We have done a retrospective review of the collected data of patients in Vardhman Mahavir Medical College and Safdarjung Hospital from August 2017 to October 2021 to find the incidence of multiple-level spinal TB and possible factors attributed to this specific disease pattern. All the patients who had been diagnosed of spinal TB either microbiologically or histopathologically or by a good clinical response to anti-tubercular treatment (ATT) and had a whole spine screening MRI film, were included. Patients of spinal TB who did not have a whole spine screening MRI were excluded from the study. Multiple-level spinal TB was diagnosed when lesions were identified in vertebral levels other than a typical paradiscal lesion, and additional lesions were separated from the primary disease by at least one normal spinal segment. RESULTS Among the patients, 242 met the inclusion criteria, and 76 showed multiple-level non-contiguous spinal TB on MRI, incidence being 31.4%. The rest of the 166 patients showed typical single-segment contiguous lesions. By doing multivariate analysis to determine the independent risk factors for multiple-level spinal TB, extremes of age (<20 years and >50 years) have been found to be a significant factor with p value of 0.0001. Though drug resistance was not found to be a significant risk factor (p value 0.051), the proportion of patients having multiple-level TB was far more in the drug-resistant group (13/76). CONCLUSIONS Single sequence whole spine screening MRI film is an effective, economical, and time-saving tool to detect multiple-level spinal TB. Along with its diagnostic accuracy, it also provides therapeutic benefits like access to a more approachable site for biopsy.
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Affiliation(s)
- Atul Sareen
- Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Mayukh Guha
- Spine Surgery, Indian Spinal Injuries Centre, New Delhi, IND
| | - Kuldeep Bansal
- Spine Surgery, Yashoda Super Speciality Hospital, Ghaziabad, IND
| | - Amit Hegde
- Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Tankeswar Boruah
- Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Bansal K, Guha M, Gupta A. Spontaneous-Onset Delayed Spinal Arachnoiditis With Dorsal Cord Herniation in a 29-Year-Old Paraplegic Patient: A Case Report. Cureus 2023; 15:e51374. [PMID: 38292951 PMCID: PMC10825720 DOI: 10.7759/cureus.51374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
Spinal adhesive arachnoiditis is a rare occurrence with a diverse etiology. The clinical picture is not universal, and varying degrees of neurodeficit have been mentioned. Spontaneous spinal cord herniation or idiopathic spinal cord herniation occurs due to displacement of the cord through a dural or arachnoid defect. We report a case of a 29-year-old male paraplegic patient with a nontraumatic spinal cord injury (SCI) following surgery for an intradural extramedullary lesion at T10-T11 level who developed loss of truncal balance after two years of the index surgery. After a thorough clinical examination and MRI as well as other investigations, the patient was diagnosed as having spontaneous-onset delayed spinal arachnoiditis with dorsal cord herniation through the laminectomy window with effacement of neural tissue and ascending edema up to T6 level. A new-onset weakness or the development of an ascending loss of sensory level with a loss of truncal balance should alarm the therapist about some new pathology happening at the cord level in patients with SCI. In this regard, spinal adhesive arachnoiditis with or without cord herniation should always be suspected in a paraplegic patient with delayed-onset deterioration of neurology. Differential diagnoses like arachnoid web and arachnoid cysts should also be kept in mind.
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Affiliation(s)
- Kuldeep Bansal
- Spine Services, Indian Spinal Injuries Center, New Delhi, IND
| | - Mayukh Guha
- Spine Services, Indian Spinal Injuries Center, New Delhi, IND
| | - Anuj Gupta
- Spine Surgery, Max Superspeciality Hospital, New Delhi, IND
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Abstract
STUDY DESIGN A retrospective case-control study. OBJECTIVE Only a few studies have studied the incidence of new-onset SI joint pain following lumbar spine fusion surgery. We aimed to explore the association between new-onset SI joint pain following Transforaminal Lumbar Interbody Fusion (TLIF) for degenerative spine disorders and changes in spinopelvic parameters. METHODS A retrospective review of hospital records and imaging database of a tertiary care institute was done for patients who underwent TLIF from October 2018 to October 2019. The 354 patients who satisfied the eligibility criteria were divided into 2 groups(Group A, new-onset SI joint pain group, n = 34 and Group B, normal controls, n = 320). Symptomatic relief (>70% reduction in the VAS [Visual Analogue Scale] score) after 15 minutes of SI joint injection was considered diagnostic of SI joint pain. Clinical and radiological spinopelvic parameters were compared between the 2 groups. RESULTS Patients with postoperative SI joint pain (Group A) had significantly less preoperative and postoperative lumbar lordosis (p < 0.001) compared to the other group. Most of the patients in Group A had a cephalad migration of the apex postoperatively (30/34 patients) whereas majority of patients in group B had either predominant caudal migration (44/320 patients) or no migration of the lumbar apex (272/320 patients). CONCLUSIONS The preoperative and postoperative lumbar lordosis are significantly less and the postoperative pelvic tilt is significantly high in patients with new-onset SI joint pain compared to the control group. The cephalad migration of the lumbar apex is significantly associated with new-onset SI joint pain.
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Affiliation(s)
| | - Kuldeep Bansal
- Department of Spine Service, 76434Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
| | - Gayatri Vishwakarma
- Department of Biostatistics, 76434Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
| | - Harvinder Singh Chhabra
- Department of Spine Service, 76434Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
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Kamal S, Sehgal A, Shahi P, Prakash C, Saurav S, Bansal K. Topical oxygen therapy in acute traumatic musculoskeletal wounds of the foot and ankle. J Wound Care 2023; 32:92-97. [PMID: 36735527 DOI: 10.12968/jowc.2023.32.2.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To quantify the reduction in wound size and change in wound quality following low-cost topical oxygen therapy (TOT) in patients with acute traumatic musculoskeletal wounds of the foot and ankle. METHOD This prospective interventional study included patients with acute traumatic musculoskeletal wounds of the foot and ankle of <3 weeks' duration after they had undergone debridement and required subsequent wound coverage. A sterile C-Arm cover was used to cover the wound and 100% oxygen was administered at 1 atm, at a rate of 10l/min for 90 minutes on each of four consecutive days, through a suction catheter connected to an oxygen cylinder. The cycle was repeated after a three-day break. Wound surface area (by plotting on graph paper) and wound quality (by modified wound infection checklist score and swabs for culture and Gram staining) were assessed before and after TOT application. RESULTS The study cohort included 20 patients ≥18 years of age. There was a statistically significant (p<0.001) reduction in mean wound surface area from 79.3cm2 at baseline to 69.6cm2 after two cycles of TOT. The mean modified wound infection checklist score was 13.6 and 0.8, respectively, before and after two cycles of TOT, suggesting statistically significant improvement (p=0.02) in wound quality. All patients showed no growth in their wound culture after TOT. CONCLUSION TOT appears to be a promising and cost-effective alternative in the management of traumatic wounds. However, future studies with larger sample sizes and control groups for comparison are needed to establish the benefit of TOT in acute traumatic musculoskeletal wounds.
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Affiliation(s)
- Sushil Kamal
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Apoorv Sehgal
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Pratyush Shahi
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Chaitanya Prakash
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Shivam Saurav
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Kuldeep Bansal
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Kalidindi KKV, Sangondimath G, Bansal K, Vishwakarma G, Chhabra HS. Introduction of a Novel “Segmentation Line” to Analyze the Variations in Segmental Lordosis, Location of the Lumbar Apex, and Their Correlation with Spinopelvic Parameters in Asymptomatic Adults. Asian Spine J 2022; 16:502-509. [PMID: 36058559 PMCID: PMC9441431 DOI: 10.31616/asj.2021.0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
Study Design Cross-sectional study. Purpose This study aimed to understand the sagittal spinopelvic parameters, segmental lumbar parameters, and lumbar apex location in asymptomatic adults and analyze their correlations with each other. Overview of Literature Roussouly and his colleagues reported that pelvic incidence (PI) influences the lower arc of lumbar lordosis, whereas Pesenti and his colleagues reported that PI influences only the proximal part of lordosis and not the distal part. Both studies have their shortcomings. Methods One hundred asymptomatic adult volunteers (mean age, 29.1±7.9 years; 69 males, 31 females) who satisfied the selection criteria were enrolled in this study. Standing antero-posterior and lateral whole spine and pelvis X-rays were performed, and the radiographic parameters were analyzed. We introduced a “segmentation line” bisecting the apical vertebra/disk to divide the upper arc of lumbar lordosis (ULL) and lower arc of lumbar lordosis (LLL). Results The mean PI was 48.02°, ULL 29.12°, LLL 16.02°, total lumbar lordosis (TLL) 45.14°, lumbar tilt angle 4.73°, and location of the apex of lumbar lordosis (LLA) 4.11°. The location of the lumbar apex moved higher as the PI increased. The PI was strongly positively correlated with the LLL (r =0.582, p <0.001) and TLL (r =0.579, p <0.001) but not with the ULL (r =0.196, p =0.05). The LLA was strongly positively correlated with the ULL (r =0.349, p <0.001), negatively with the LLL (r =−0.63, p <0.001), and not correlated with the TLL (r =−0.177, p =0.078). Conclusions The PI influences the location of the lumbar apex, the LLL, and the TLL but not the ULL. The location of the lumbar apex significantly influences the segmental lordosis but not the TLL.
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Affiliation(s)
- Kalyan Kumar Varma Kalidindi
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
- Corresponding author: Kalyan Kumar Varma Kalidindi Indian Spinal Injuries Center, Vasant Kunj, New Delhi, Delhi-110070 India Tel: +91-9597732908, Fax: +91-1142255200, E-mail:
| | | | - Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
| | - Gayatri Vishwakarma
- Department of Biostatistics, Indian Spinal Injuries Center, New Delhi, India
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Bansal K, Prasad A, Singh S, Chauhan A, Singla S. Pathological Femoral Shaft Fracture With McCune-Albright Syndrome With Hyperthyroidism Managed With Oral Alendronate: A Case Report. Cureus 2022; 14:e26802. [PMID: 35971343 PMCID: PMC9373833 DOI: 10.7759/cureus.26802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 11/21/2022] Open
Abstract
McCune-Albright syndrome (MAS) is a complex endocrinopathy with polyostotic fibrous dysplasia and café-au-lait spots. Pathological femoral shaft fracture along with MAS is not a common occurrence. Bisphosphonates can be used for the management of pathological fractures. A seven-year-old male child presented with pathological femoral shaft fracture with MAS (café-au-lait macules and hyperthyroidism). The patient was managed conservatively with closed reduction along with hip spica and oral alendronate. Fracture consolidation occurred within six to eight weeks with improvement in bone pains. Oral alendronate can be used as an adjuvant to conservative therapy for pathological fracture in MAS in children.
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Saurav S, Aggarwal AN, Shahi P, Kamal S, Bansal K, Singla S. Efficacy of Single Injection of Platelet-Rich Plasma in Shoulder Impingement Syndrome. Cureus 2022; 14:e25727. [PMID: 35812631 PMCID: PMC9270084 DOI: 10.7759/cureus.25727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction To analyze the change in Visual Analog Scale (VAS), QuickDASH score, and the range of motion at the shoulder joint following a single injection of platelet-rich plasma (PRP) in shoulder impingement syndrome. Methods Twenty patients (21 shoulders) of either sex above the age of 18 years with a clinical diagnosis of shoulder impingement having a positive shoulder impingement test (positive Hawkins-Kennedy impingement test and/or positive Neer's impingement sign), ultrasonographic confirmation of shoulder impingement, and a failure to respond to standard non-operative methods for a minimum period of four weeks were included in this prospective interventional study. PRP was injected at the proposed site. At three months after the injection, the changes in the VAS, QuickDASH score, and the range of motion at the shoulder joint were analyzed. Results There were significant changes in the VAS, QuickDASH score, and range of motion at the shoulder joint following a single injection of PRP. Conclusions Platelet-rich plasma (PRP) injection results in a significant decrease in pain and improvement in the range of motion and an overall excellent functional outcome in shoulder impingement syndrome. However, future studies with a bigger sample size and longer follow-up are needed.
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Bansal K, Singh S, Gupta A, Chhabra HS, Kalidindi KKV. Extraosseous Spread of Multiple Myeloma Mimicking Pancoast Tumor. Cureus 2022; 14:e22412. [PMID: 35345749 PMCID: PMC8942157 DOI: 10.7759/cureus.22412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/20/2022] Open
Abstract
A 55-year-old man presented with upper backache for one month, inability to move both the lower limbs for two weeks and retention of urine for five days. Examination revealed spastic paraplegia and reduced breath sounds in the right upper zone. Initial imaging revealed a soft tissue lesion in the apex of the right lung, suggesting a Pancoast tumor. It also showed a lytic, expansile lesion of the T2 vertebra extending to the right second posterior rib on subsequent imaging. High serum calcium, M-spike in beta-gamma globulin region on serum electrophoresis, 50%-60% plasmacytoid cells on bone marrow aspiration, concertina collapse of the vertebral body, and pattern of neurological deficit pointed towards multiple myeloma. T2 corpectomy and mesh cage placement, C7-T4 posterior stabilization, and resection of the second rib were done. Histopathology confirmed multiple myeloma. Postoperatively, the patient was managed with radiotherapy and bortezomib. The patient had a good neurological recovery. Timely intervention is critical for disease control and leads to better recovery.
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Bansal K, Singh S, Mallepally AR, Shahi P. Rapid Recurrence of Giant Cell Tumour of C2 Vertebra After Long-Term Denosumab Following Surgical Resection. Cureus 2022; 14:e22000. [PMID: 35282561 PMCID: PMC8906507 DOI: 10.7759/cureus.22000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 11/20/2022] Open
Abstract
A 25-year-old man presented with symptoms of cervical myelopathy for 10 days. Imaging revealed an expansile, lytic lesion involving the C2 vertebra completely and compressing the spinal cord, suggestive of giant cell tumor (GCT). Tumor resection and posterior stabilization from C1-C4 were done. Histopathology confirmed the diagnosis of GCT. The patient was kept on adjuvant Denosumab (D-ab) for two years with no signs of recurrence. However, discontinuation of D-ab therapy led to recurrence of the tumor within three months, which was managed with repeated surgical resection and anterior instrumentation followed by radiotherapy. To the best of our knowledge, this is the first reported case of GCT involving the upper cervical spine with rapid recurrence following the stoppage of D-ab therapy.
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Kalidindi KKV, Bansal K, Biswas G, Gupta A, Vishwakarma G, Tandon V, Chhabra HS. Surgical Outcomes of Transpedicular Decompression with or without Global Reconstruction in Thoracic/Thoracolumbar Pott's Spine: A 7-Year Institutional Retrospective Study. Asian Spine J 2021; 16:173-182. [PMID: 34883011 PMCID: PMC9066257 DOI: 10.31616/asj.2021.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022] Open
Abstract
Study Design Retrospective case-control study. Purpose This study aimed to analyze the radiological and clinical outcomes of transpedicular decompression in spinal tuberculosis (or Pott’s spine) with and without anterior reconstruction using polyetheretherketone (PEEK) or mesh cage. Overview of Literature The outcomes of transpedicular decompression with and without global reconstruction in Pott’s spine are insufficiently investigated. Additionally, the use of PEEK cages in Pott’s spine has remained unestablished. Methods Using the hospital records and imaging database obtained from January 2014 to January 2020, this study retrospectively analyzed patients who underwent surgery for Pott’s spine and met the eligibility criteria. Results This study included 230 patients with a mean±standard deviation age of 47.7±18.1 years (109 males, 121 females). The Visual Analog Scale score, Oswestry Disability Index, and Cobb angle were significantly improved in these patients (p<0.001). Patients who underwent anterior reconstruction had a greater correction in Cobb angle postoperatively (p=0.042) but also had a greater blood loss (p=0.04). During the follow-up, they experienced a significant loss of correction compared with those who only underwent transpedicular decompression (p=0.026). Nevertheless, patients who underwent anterior reconstruction using mesh/PEEK cages showed no significance difference in the clinical or radiological outcomes. Conclusions Transpedicular decompression used in the surgical management of Pott’s spine showed favorable clinical and radiological outcomes. The additional use of anterior reconstruction obtained equivalent clinical outcomes but resulted in excessive blood loss. Meanwhile, the use of mesh/PEEK cage for anterior reconstruction did not affect the clinical and radiological outcomes.
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Affiliation(s)
| | - Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
| | - Gourab Biswas
- Department of Orthopaedics, Guru Tej Bahadur Hospital, New Delhi, India
| | - Anuj Gupta
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
| | - Gayatri Vishwakarma
- Department of Biostatistics, Indian Spinal Injuries Center, New Delhi, India
| | - Vikas Tandon
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
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Sarkar B, Munshi A, Ganesh T, Rastogi K, Bansal K, Manikandan A, Mohanti BK, Pradhan A. Personal, Social, Economic and Professional Challenges Faced by Female Radiation Oncologists in South Asia. Clin Oncol (R Coll Radiol) 2021; 34:e81-e82. [PMID: 34810070 DOI: 10.1016/j.clon.2021.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/20/2021] [Accepted: 11/02/2021] [Indexed: 11/03/2022]
Affiliation(s)
- B Sarkar
- Department of Radiotherapy, Apollo Multispeciality Hospitals, Kolkata, India; Department of Physics, GLA University, Mathura, India.
| | - A Munshi
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - T Ganesh
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - K Rastogi
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - K Bansal
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - A Manikandan
- Department of Medical Physics, Apollo Proton Cancer Center, Chennai, India
| | - B K Mohanti
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - A Pradhan
- Department of Mathematics, GLA University, Mathura, India
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Abstract
A ruptured Baker's cyst is a rare presentation and may mimic deep vein thrombosis (DVT) or acute thrombophlebitis. In rare cases, it may present with infection or compartment syndrome. We present our experience related to a case of a ruptured Baker's cyst and its management. A 54-year-old female presented to us with knee pain, which was initially managed conservatively. After six weeks, she came to us with severe pain and swelling in her left calf and foot. It was an acute presentation and DVT was suspected initially. Ultrasound color Doppler showed no DVT and then MRI revealed it to be a ruptured Baker's cyst. The patient was subsequently managed conservatively and her condition improved in 12 weeks of follow-up. A high index of suspicion and knowledge is required to diagnose a ruptured Baker's cyst, and most of the patients respond well to conservative management.
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Affiliation(s)
- Kuldeep Bansal
- Spine Surgery, Indian Spinal Injuries Center, Delhi, IND
| | - Anuj Gupta
- Orthopedics & Spine, Triveni Ortho & Spine Center, Delhi, IND.,Spine, Max Superspeciality Hospital, Delhi, IND
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Sarkar B, Munshi A, Shahid T, Sengupta S, Bhaskar R, Ganesh T, Paul A, Bhattacharjee B, Pun R, Imbulgoda N, Biswal S, Rastogi K, Bansal K, Baba A, Yasmin T, Bhattacharya J, Ghosh T, De A, Chatterjee P, Pradhan A. Growth Characteristics of Woman Radiation Oncologists in South Asia: Assessment of Gender Neutrality and Leadership Position. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Gautam V, Patil PP, Bansal K, Kumar S, Kaur A, Singh A, Korpole S, Singhal L, Patil PB. Description of Stenotrophomonas sepilia sp. nov., isolated from blood culture of a hospitalized patient as a new member of Stenotrophomonas maltophilia complex. New Microbes New Infect 2021; 43:100920. [PMID: 34457314 PMCID: PMC8379335 DOI: 10.1016/j.nmni.2021.100920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 11/27/2022] Open
Abstract
Stenotrophomonas sepilia strain SM16975 (= JCM 32102; = KCTC 62052) is a new species isolated from the blood culture of a hospitalized patient. The biochemical characterization, phenotypic criteria, phylogenomic reconstruction, and genomic analysis were carried out to differentiate it from its phylogenetic neighbours, establishing novel species status in the genus Stenotrophomonas and within Stenotrophomonas maltophilia complex (Smc).
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Affiliation(s)
- V Gautam
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P P Patil
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - K Bansal
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - S Kumar
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - A Kaur
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - A Singh
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - S Korpole
- CSIR- Institute of Microbial Technology, Chandigarh, India
| | - L Singhal
- Department of Microbiology, Government Medical College & Hospital, Chandigarh, India
| | - P B Patil
- CSIR- Institute of Microbial Technology, Chandigarh, India
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17
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Nanda A, Bansal K, Gupta A, Verma K, Manghwani J, Chhabra HS. Multilevel thoracic and lumbar ligamentum flavum ossification in an achondroplasic-a rare presentation. Spinal Cord Ser Cases 2021; 7:69. [PMID: 34333511 DOI: 10.1038/s41394-021-00427-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Achondroplasia is a rare autosomal dominant condition characterized by stenosis in spinal canal. Multilevel Ossification of the ligamentum flavum in the spine is a rare occurrence which too can contribute to stenosed canal. CASE PRESENTATION We report a case of an Indian achondroplasic dwarf with multilevel ossification of ligamentum flavum (OLF) at thoracic and lumbar segment. She presented in the outpatient department with bilateral weakness in legs with complete foot drop on the left side and was non-ambulatory. She was managed surgically by instrumentation with multiple interbody fusions with wide decompression and excision of OLF. The patient responded well to the surgery and became a walker after 2-year follow-up. DISCUSSION Achondroplasic patients may present rarely with multiregional and multilevel OLF. It is important to identify them preoperatively so as to have good surgical outcome. Wide laminectomy, removal of the ossified ligament, and fusion with instrumentation resulted in the improvement of the patient's neurological symptoms and functions.
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Affiliation(s)
- Ankur Nanda
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India
| | - Kuldeep Bansal
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India
| | - Anuj Gupta
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India.
| | - Kalyan Verma
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India
| | - Jitesh Manghwani
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India
| | - H S Chhabra
- Department of Spine Surgery, Indian Spinal Injuries Center, New Delhi, India
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Srivastava S, Mahor A, Singh G, Bansal K, Singh PP, Gupta R, Dutt R, Alanazi AM, Khan AA, Kesharwani P. Formulation Development, In Vitro and In Vivo Evaluation of Topical Hydrogel Formulation of Econazole Nitrate-Loaded β-Cyclodextrin Nanosponges. J Pharm Sci 2021; 110:3702-3714. [PMID: 34293406 DOI: 10.1016/j.xphs.2021.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/17/2022]
Abstract
Econazole nitrate, an antifungal drug used in the handling of skin ailments, is commercially not efficient as these ailments typically require a more elevated concentration of the drug to offer an effective pharmacological retort. Like so, it is proposed to assess the effectiveness of the topical hydrogel of econazole-loaded nanosponge in the management of skin ailment(s). Econazole nitrate-laden β-cyclodextrin nanosponges were developed by employing the melt method using β-cyclodextrin as the organic polymer and N,N-carbonyldiimidazole as the crosslinker. The critical factors disturbing the quality of the formulation were uniquely identified by the Ishikawa diagram, and they were optimized by the statistical experiment design concept. β-cyclodextrin loaded nanosponges were uniquely designed using the Placket-Burman approach and optimized utilizing the Box-Behnken method. The optimized nanosponges (EN-CDN) were 421.37 ± 6.19 nm in size with an entrapment efficiency of 70.13% ± 5.73%. The topical hydrogel of nanosponges (EN-TG) was prepared using carbopol 934 and pyrrolidone as permeation enhancers. In vitro skin permeation studies affirmed the improved transport crosswise the goatskin for topical hydrogel in comparison to the marketed product. EN-TG was able to control the fungal infection in the selected animal model in comparison to the marketed preparation. Stability studies reported favorably that nanogel remained stable under normal and accelerated settings.
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Affiliation(s)
| | - Alok Mahor
- Institute of Pharmacy, Bundelkhand University, Jhansi, India 284128.
| | - Gyanendra Singh
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology, Banaras Hindu University, (IIT-BHU), Varanasi, India 221005
| | - Kuldeep Bansal
- Pharmaceutical Science Laboratory, Faculty of Science and Engineering, Abo Akademi University, Turku, Finland 20520
| | | | - Rishikesh Gupta
- Institute of Pharmacy, Bundelkhand University, Jhansi, India 284128
| | - Rohit Dutt
- School of Medical and Allied Sciences, G.D. Goenka University, Gurgaon Sohna Road, Gurgaon, India 122103
| | - Amer M Alanazi
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Azmat Ali Khan
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
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Gupta A, Das K, Bansal K, Singh Chhabra H, Arora M. Should Implant Breakage Be Always Considered as Implant "Failure" in Spine Surgery: Analysis of Two Cases and Literature Review. Cureus 2021; 13:e15233. [PMID: 34178543 PMCID: PMC8223761 DOI: 10.7759/cureus.15233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The advancement in the material of spinal implant and technique of spinal instrumentation has led to an increase in spine surgeries. The final desired outcome of spine surgery involving instrumentation is fusion. There is a race among implants to fail and bone to fuse. If there is a formation of pseudoarthrosis or failure to fuse then implants are bound to fail. The most common presentation of pseudoarthrosis is implant breakage. Hence, should we label every implant that has presented with breakage as a "failure"? In this article, we have discussed our experience of two cases presented to us with implant breakage but which were managed successfully with conservative methods. Both of our cases did well without any surgical intervention. We have follow-ups of seven years in one case and five years in the other. Every patient with pseudoarthrosis does not require surgical management and hence, every implant breakage should not be labeled as implant "failure".
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Affiliation(s)
- Anuj Gupta
- Orthopedics and Spine, Triveni Ortho and Spine Center, New Delhi, IND
| | - Kalidutta Das
- Spine Surgery, Indian Spinal Injuries Center, New Delhi, IND
| | - Kuldeep Bansal
- Orthopedics, Indian Spinal Injuries Center, New Delhi, IND
| | | | - Mohit Arora
- Orthopedics, Narayana Superspeciality Hospital, New Delhi, IND
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Kalidindi KKV, Sharma JK, Bansal K, Vishwakarma G, Chhabra HS. Radiological changes in sagittal parameters after C1-C2 arthrodesis and their clinical correlation: Is there a difference between traumatic and non-traumatic causes? Int J Neurosci 2021; 133:505-511. [PMID: 33980113 DOI: 10.1080/00207454.2021.1929213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Compensatory changes in cervical sagittal alignment after C1-C2 arthrodesis have been reported in a few studies. No studies have explored the differences in these compensatory changes between traumatic and non-traumatic pathologies. Conflicting reports exist on the correlation between cervical sagittal parameters and neck pain or function.Methodology: Medical records of 81 consecutive patients [Jan 2010 - Dec 2018] who underwent Harms arthrodesis were retrospectively reviewed. 53 patients were included in the final analysis. Radiological parameters [C0-C1, C1-C2, C2-C7 angles and T1 slope] and clinical parameters [VAS (Visual analogue scale) and NDI (Neck disability index)] were compared between the two groups, Group A (traumatic) and Group B (non-traumatic).Results: The 53 patients [Group A (n = 24,) and Group B (n = 29)] had a mean age of 49.98 ± 21.82 years (42 males, 11 females). Mean follow up duration was 48.9 months. Δ C1-C2 angle is significantly correlated with ΔC2-C7 angle (Group A, p = 0.004; Group B, p = 0.015) but not with ΔC0-C1 angle (Group A, p = 0.315; Group B, p = 0.938). Though significant improvement in the clinical parameters (VAS/NDI) has been noted in both groups, Group A showed a greater improvement in VAS scores [Group A, (p < 0.001); Group B, (p < 0.023)].Conclusions: The sub-axial sagittal profile was strongly correlated with the ΔC1-C2 angle in both groups. Group B showed greater changes in sagittal parameters after Harms fixation and Group A showed greater improvement in long-term functional outcomes. The final functional outcomes were not related to the initial or final radiological sagittal profile in both groups.
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Affiliation(s)
| | - Jeevan Kumar Sharma
- Department of Spine Service, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, India
| | - Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, India
| | - Gayatri Vishwakarma
- Department of Biostatistics, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, India
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21
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Shahi P, Chadha M, Sehgal A, Sudan A, Meena U, Bansal K, Batheja D. Sagittal Balance, Pulmonary Function, and Spinopelvic Parameters in Severe Post-Tubercular Thoracic Kyphosis. Asian Spine J 2021; 16:394-400. [PMID: 33957743 PMCID: PMC9260405 DOI: 10.31616/asj.2020.0464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Study Design Cross-sectional study. Purpose To evaluate sagittal balance, pulmonary function, and spinopelvic parameters in patients with healed spinal tuberculosis with severe thoracic kyphosis. Overview of Literature Deterioration of neurological function is an absolute indication of surgical intervention in severe post-tubercular kyphosis, but the relationship of compromise in lung function and spinal alignment with severity of kyphosis is still unclear. Methods Twenty patients (age, 14–60 years) with healed spinal tuberculosis with thoracic kyphosis >50° were included. Lateral-view radiography of the whole spine, including both hips, was performed for assessment of kyphotic angle (K angle), sagittal balance, lumbar lordosis, and spinopelvic parameters. Pulmonary function was assessed by measuring the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and their ratio (FEV1/FVC) by spirometry. Results A positive correlation between severity of kyphosis and sagittal imbalance was noted, with compensatory mechanisms maintaining the sagittal balance in only up to 80° of dorsal kyphosis. In >80° of kyphosis, FVC was found to be markedly decreased (mean FVC=50.6%). The mean K angle was lower in subjects with lower thoracic kyphosis. In lower thoracic kyphosis, due to short lordotic and long kyphotic curves, both lumbar lordosis and pelvic retroversion worked at compensation, whereas, in middle thoracic kyphosis, due to long lordotic curve, only lumbar lordosis was required. Normal pulmonary function (mean FVC, 83.0%) and lesser kyphotic deformity (mean K angle in adolescents, 69.8°; in adults, 94.4°) were found in adolescents. Conclusions In >80° of thoracic kyphosis, there is sagittal imbalance and a markedly affected pulmonary function. Such patients should be offered corrective surgery if they are symptomatic and medically fit to undergo the procedure. However, whether the surgical procedure would result in improved pulmonary function and sagittal balance needs to be evaluated by a follow-up study.
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Affiliation(s)
- Pratyush Shahi
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Manish Chadha
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Apoorv Sehgal
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Aarushi Sudan
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Umesh Meena
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Kuldeep Bansal
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Dheeraj Batheja
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
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22
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Bansal K, Kalidindi KKV, Gupta A, Surapaneni VN, Kapur R, Chhabra HS. An extremely rare presentation of AV fistula: Massive destruction of multiple vertebral bodies with paraparesis. Surg Neurol Int 2021; 12:123. [PMID: 33880228 PMCID: PMC8053452 DOI: 10.25259/sni_875_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background Spinal ventral epidural arteriovenous fistulas (EDAVFs) are rare and underdiagnosed entities and usually present with benign symptoms such as radiculopathy. To the best of our knowledge, EDAVFs presenting with massive vertebral body destruction have not been reported in the literature. Case Description A young male presented with mid back pain for 1 year and weakness of both lower limbs for 3 months. He was clinicoradiologically diagnosed with spinal tuberculosis and started on antitubercular treatment elsewhere. Radiological investigations suggested destruction and collapse of T12 and L1 vertebrae. Prominent flow voids were seen in T9-L2 epidural space, likely prominent epidural vessels. The primary differential diagnoses were spinal tuberculosis and neoplastic etiologies. T9 to L3 surgical stabilization and anterior decompression by pediculectomy of left T12 and L was done. The surgeon encountered massive bleeding at the time of anterior decompression and a vascular etiology was suspected. Biopsy revealed negative results for infection or malignancy. DSA revealed ventral EDAVFs, and hence, transcatheter embolization was performed. He had excellent outcome on assessment at 21 months postoperative follow-up. Conclusion Spinal epidural AVFs can rarely present with gross vertebral body destruction and paraparesis. Preoperative radiological assessment with suspicion of spinal epidural AVFs can help to avoid intraoperative difficulties and complications. Timely, management of spinal epidural AVFs can result in excellent outcomes.
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Affiliation(s)
- Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
| | | | - Anuj Gupta
- Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India
| | | | - Rajesh Kapur
- Department of Radiology, Indian Spinal Injuries Center, New Delhi, India
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23
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Singh D, Dhammi IK, Jain A, Shahi P, Kumar S, Bansal K. Osteosynthesis in femoral neck fracture in two patients with ipsilateral lower limb amputation. BMJ Case Rep 2021; 14:14/3/e239060. [PMID: 33766963 PMCID: PMC8006772 DOI: 10.1136/bcr-2020-239060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Femoral neck fracture in lower limb amputees poses treatment problems. The altered biomechanics of the hip in amputees, stump length, associated osteoporosis and difficulty in positioning these patients on the operation table are few of the technical challenges faced by an operating surgeon especially while salvaging the native hip joint. We report a case series of two lower limb amputee patients with fracture neck of femur in whom we salvaged the native hip joint by performing osteosynthesis. We observed satisfactory results of osteosynthesis in both of our patients on follow-up, with both achieving pretrauma ambulatory status in 6-8 weeks postoperatively. We concluded that each lower limb amputee patient with fracture neck of femur should be carefully evaluated on presentation and managed individually. These patients can be positioned and managed by osteosynthesis on a standard operating table or fracture table without requiring any special operating theatre set-up (traction devices).
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Affiliation(s)
- Deepak Singh
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
| | - Ish Kumar Dhammi
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
| | - Archit Jain
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
| | - Saurabh Kumar
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
| | - Kuldeep Bansal
- Orthopaedics, University College of Medical Sciences, Delhi, Delhi, India
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Gupta A, Bansal K, Kalidindi KKV, Bhargava A, Verma A. Intradural Conus Medullaris Lipoma With Neurological Deficit: A Rare Occurrence. Cureus 2021; 13:e14053. [PMID: 33898137 PMCID: PMC8059682 DOI: 10.7759/cureus.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Intradural lipoma without spinal dysraphism is a rare occurrence. Most of them are asymptomatic but can also present with neurological deficits. A 54-year-old male patient presented to us with progressive weakness in both lower limbs for six months. On physical examination and radiological workup, intradural lipoma was diagnosed. Due to progressive neurological deficit, the patient was treated surgically. On 2.5 years of follow-up, the patient showed complete neurological recovery. Intradural lipomas can also present with the neurological deficit at any age and should be managed surgically if the deficit is progressive in nature. Surgical management has a good outcome if done within two years of onset of symptoms.
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Affiliation(s)
- Anuj Gupta
- Department of Orthopedics and Spine, Max Super Speciality Hospital, New Delhi, IND
| | - Kuldeep Bansal
- Department of Spine Services, Indian Spinal Injuries Center, New Delhi, IND
| | | | - Aayush Bhargava
- Department of Orthopedics, University College of Medical Sciences, Guru Teg Bahadur Hospital, New Delhi, IND
| | - Aditya Verma
- Department of Orthopedics, Indian Spinal Injuries Center, New Delhi, IND
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25
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Gupta A, Bansal K, Chhabra HS, Shahi P. Severe Form of Bacterial Meningitis After Spine Surgery: A Case Report and Review of the Literature. Cureus 2021; 13:e13877. [PMID: 33868841 PMCID: PMC8043217 DOI: 10.7759/cureus.13877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 11/08/2022] Open
Abstract
Meningitis after spine surgery is a rare complication. In this report, we aim to discuss the case of a male patient who developed this rare condition after undergoing cervical spine surgery with devastating outcomes. We also engage in a review of the relevant literature. A 17-year-old boy presented with post-traumatic cervical kyphotic deformity with signs of cord compression. He was operated in three stages, all conducted in a single sitting. There was an incidental cerebrospinal fluid (CSF) leak, which was primarily repaired. On the fourth postoperative day, the patient developed altered sensorium and seizures. Evaluations for clinical signs of meningitis such as neck rigidity and Kernig's sign were inconclusive. CSF analysis confirmed the diagnosis of meningitis. Thereafter, the patient developed hydrocephalus and intractable infection, for which multiple procedures were done. Finally, we succeeded in controlling the infection, but the patient developed a neurological deficit, which did not resolve even after 2.5 years of follow-up. The clinical signs and symptoms of meningitis after cervical spine surgery are not very clear or suggestive. A strong index of suspicion should be maintained for the early detection of this condition to prevent devastating complications that result from it.
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Affiliation(s)
- Anuj Gupta
- Orthopaedics and Spine, Triveni Ortho & Spine Center, Delhi, IND
| | - Kuldeep Bansal
- Spine Surgery, Indian Spinal Injuries Center, Delhi, IND
| | | | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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26
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Rastogi K, Sarkar B, Munshi A, Ganesh T, Bansal K, Pandey V, Mohanti B. Analysis of Medical Tourism of Cancer patients in Asia-Africa-Oceania region and Financial Toxicity due to Migration. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Sarkar B, Munshi A, Shahid T, Ganesh T, Mohanti B, Bansal K, Rastogi K, Chaudhari B, Manikandan A, Biswal S, Bhattacharya J, Ghosh T, De A, Roy Chowdhury S, Mandal S, George K, Mukherjee M, Gazi M, Chauhan R, Chatterjee P. Challenges Faced by Woman Radiation Oncologists (WRO) in South Asia. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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28
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Kalidindi KKV, Bansal K. Letter to the Editor: Determination of Any Correlation between Sagittal Spinopelvic Configuration and Progressive Collapse of Acute Osteoporotic Compression Spine Fractures: A Retrospective Radiological Analysis. Asian Spine J 2020; 14:768-769. [PMID: 33108843 PMCID: PMC7595812 DOI: 10.31616/asj.2020.0453.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Kalyan Kumar Varma Kalidindi
- Department of Spine Service, Indian Spinal Injuries Centre, New Delhi, India
- Corresponding author: Kalyan Kumar Varma Kalidindi, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070 India Tel: +91-9597732908, Fax: +91-011-26898810, E-mail:
| | - Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Centre, New Delhi, India
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29
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Kalidindi KKV, Bansal K. Letter to the Editor: Clinical Implication of Mid-Range Dynamic Instability in Lumbar Degenerative Spondylolisthesis. Asian Spine J 2020; 14:764-765. [PMID: 33108841 PMCID: PMC7595821 DOI: 10.31616/asj.2020.0412.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Kalyan Kumar Varma Kalidindi
- Department of Spine Service, Indian Spinal Injuries Centre, New Delhi, India
- Corresponding author: Kalyan Kumar Varma Kalidindi Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070 India Tel: +91-9597732908, Fax: +91-011-26898810, E-mail:
| | - Kuldeep Bansal
- Department of Spine Service, Indian Spinal Injuries Centre, New Delhi, India
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Abstract
A 22-year-old female presented with painful, progressive swelling of the right forearm for six months. Physical examination revealed a 7 cm x 5 cm firm, tender soft-tissue swelling over the anterior aspect of the right proximal forearm with normal overlying temperature. X-rays showed increased soft tissue shadow but without any bony involvement. Serum alkaline phosphatase, serum lactate dehydrogenase, and leukocyte count were raised. MRI of the right forearm revealed enhancing soft tissue lesion with internal hemorrhagic and necrotic components involving the flexor carpi radialis muscle. Core biopsy confirmed the diagnosis of extraosseus Ewing's sarcoma. Neoadjuvant chemotherapy, wide local tumor excision, and adjuvant chemotherapy and radiotherapy were done. The patient then lost to follow-up and presented again after six months with a fungating mass and neurovascular involvement for which an above-elbow amputation was done. We, through this case report, aim to discuss the clinical and radiological findings, line of management, and the importance of early detection and treatment and a regular follow-up for extraosseus Ewing's sarcoma of the extremity.
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Affiliation(s)
- Kuldeep Bansal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Avijeet Prasad
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Apoorv Sehgal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Sushil Kamal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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Flynn-Evans EE, Hilditch CJ, Chachad R, Bansal K, Wong LR, Santamaria A, Bathurst NG, Feick NH, Garcia J. 0078 Influence of Light on Brain Activity Upon Waking From Slow Wave Sleep. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Waking from sleep is associated with reduced alertness due to sleep inertia. Light acutely improves alertness during sleep deprivation. In this study we assessed the influence of light on brain activity and connectivity after waking from slow wave sleep (SWS).
Methods
Twelve participants kept an actigraphy-confirmed stable sleep schedule with 8.5 hours for five nights and five hours for one night prior to an overnight laboratory visit. Participants completed two three-minute Karolinska Drowsiness Tests (KDT) before going to bed at their habitual bedtime. They were monitored continuously using high-density EEG (32-channel; Brain Products GmbH). Participants were woken twice and exposed to red light (0.01 melanopic-lux; control) or blue-enriched light (63.62 melanopic-lux) for one hour, in a randomized order, following at least five minutes of SWS. EEG artifact were removed algorithmically and the spectral composition of each electrode (i.e., fast fourier transform, FFT) and effective connectivity (i.e., partial directed coherence, PDC) between each electrode were estimated. A graphical analysis was conducted to extract features relevant to the facilitation of efficient communication between electrodes. All data were averaged within frequency bins of interest that correspond to delta (1-3Hz), theta (4-7Hz), alpha (8-12Hz), and beta (13-25Hz) bands and expressed relative to the pre-sleep baseline.
Results
Compared to the pre-sleep baseline, participants exposed to blue-enriched light experienced reduced theta and alpha activity; however, these results were not significantly different from the control. In contrast, the communication of frontal electrodes significantly increased across all frequency bands compared to the control, and this effect was most prominent in the alpha (t(11)=3.80, p=.005) and beta bands (t(11)=3.92, p=.004).
Conclusion
Exposure to blue-enriched light immediately after waking from SWS may accelerate the process of waking and help to improve alertness by facilitating communication between brain regions. Future analyses will explore the temporal persistence and granularity of the communicative properties associated with this response.
Support
Naval Postgraduate School Grant. NASA Airspace Operations and Safety Program, System-Wide Safety Project.
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Affiliation(s)
- E E Flynn-Evans
- Fatigue Countermeasures Lab, NASA Ames Research Center, Moffett Field, CA
| | - C J Hilditch
- Fatigue Countermeasures Lab, SJSU Research Foundation, Moffett Field, CA
| | - R Chachad
- Fatigue Countermeasures Lab, SJSU Research Foundation, Moffett Field, CA
| | | | - L R Wong
- Fatigue Countermeasures Lab, SJSU Research Foundation, Moffett Field, CA
| | - A Santamaria
- University of South Australia, Adelaide, AUSTRALIA
| | - N G Bathurst
- Fatigue Countermeasures Lab, SJSU Research Foundation, Moffett Field, CA
| | - N H Feick
- Fatigue Countermeasures Lab, SJSU Research Foundation, Moffett Field, CA
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Bansal K, Mishra P, Chadha M, Shahi P, Anshuman R, Aggarwal AN. Outcome of Dome Osteotomy With Plate Osteosynthesis for Genu Valgum in Late Adolescents and Young Adults. Cureus 2020; 12:e7894. [PMID: 32489748 PMCID: PMC7255559 DOI: 10.7759/cureus.7894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim To evaluate the degree of correction and outcomes after correction of genu valgum deformity using dome osteotomy with plate osteosynthesis in late adolescents and young adults. Methods A total of 27 knees in 21 patients underwent correction using dome osteotomy fixed with 3.5-mm low-profile proximal humeral locking system (PHILOS) plate. The functional, clinical, and radiological assessments were performed preoperatively and at six months postoperatively. Functional assessment was performed using the Bostman score, while clinical and radiological assessments were performed by measuring intermalleolar distance, tibiofemoral angle, mechanical lateral distal femoral angle, and mechanical axis deviation. All values were compared preoperatively and postoperatively using the paired t-test and Wilcoxon’s test. Results The comparison between preoperative and postoperative data was statistically significant (P<0.0001). Twenty patients had an excellent knee score, and one patient had a good score. None had an unsatisfactory score. Conclusions Dome osteotomy fixed with well-contoured, 3.5-mm low-profile PHILOS plate allows deformity correction at the CORA (center of rotation of angulation) of the knee and permits early knee mobilization without significant procedure or implant-related complications with excellent outcomes.
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Affiliation(s)
- Kuldeep Bansal
- Orthopaedics, University College of Medicine Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Puneet Mishra
- Orthopaedics, University College of Medicine Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Manish Chadha
- Orthopaedics, University College of Medical Sciences, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Rahul Anshuman
- Orthopaedics, University College of Medicine Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Aditya N Aggarwal
- Orthopaedics, University College of Medicine Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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Abstract
Fracture of the capitellum is a rare injury, accounting for about 1% of the fractures around the elbow. We report the case of a young adult with elbow pain and swelling presenting to us three weeks after the injury. Radiographs suggested a comminuted fracture of the capitellum extending medially to the trochlea. Using the anterolateral approach to the elbow, an open reduction and internal fixation of the fracture with screws was done. The procedure had an excellent functional outcome. Through this case report, we aim to highlight the importance of radiographic assessment and decision-making regarding the surgical approach and choice of the implant in the treatment of comminuted capitellar fractures.
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Affiliation(s)
- Apoorv Sehgal
- Orthopaedics, University College of Medical Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Kuldeep Bansal
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Ahmer Zafar
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Siddharth Pathak
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
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Bansal K, Shahi P, Jain AK, Dhammi IK, Kumar S. Extended Curettage and Fibular Grafting in Enchondroma of the Acromion. Cureus 2020; 12:e7630. [PMID: 32399362 PMCID: PMC7213675 DOI: 10.7759/cureus.7630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report the case of a six-year-old male child with progressive pain and swelling of the right shoulder for six months. On examination, there was a 7x7 cm globular, tender swelling with firm consistency over the posterolateral corner of the right shoulder. Radiographs showed an expansile lytic lesion in the acromion process of the scapula. Biopsy showed lobules of hypocellular cartilage separated by fibroconnective stroma suggestive of an enchondroma. Extended curettage and fibular bone grafting of the lesion was done. At one-year follow-up, the patient was symptom-free and had full, painless shoulder range of motion. To the best of our knowledge, there is no published record of an enchondroma of the acromion.
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Affiliation(s)
- Kuldeep Bansal
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Anil K Jain
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Ish K Dhammi
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Saurabh Kumar
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
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Batheja D, Sehgal A, Prasad A, Shahi P, Bansal K. Giant Cell Tumor of the Calcaneus. Cureus 2020; 12:e7467. [PMID: 32351846 PMCID: PMC7187992 DOI: 10.7759/cureus.7467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 17-year-old female presented to us with pain and swelling in the right heel. Examination revealed the swelling to be tender, hard and fixed to the calcaneus. Radiographs showed an expansile, lytic lesion of the calcaneus with well-defined margins and no extraosseus spread. A core biopsy was done which showed multinucleated giant cells in a sea of mononuclear stromal cells, suggestive of a giant cell tumour (GCT). Curettage and filling up of the defect with bone cement was done under anaesthesia. The patient was fully ambulatory three months after the surgery. At two-year follow-up, the patient continued to be asymptomatic and radiographs revealed no signs of recurrence. It is important to note that GCT can occur in these rare sites and unusual age groups, and hence requires a good level of awareness of the surgeon and adequate preoperative workup, including biopsy, before proceeding to the definitive treatment of the lesion. Considering its potential local aggressiveness, early intervention is necessary. The patient should be kept under regular follow-up to detect any recurrence or metastasis in early stage.
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Affiliation(s)
- Dheeraj Batheja
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Apoorv Sehgal
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Avijeet Prasad
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Kuldeep Bansal
- Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND
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Sarkar B, Rastogi K, Munshi A, Ganesh T, Bansal K, Tiwari S, Tyagi B, Mohanti B. Audit of Financial, Social and Logistic Concerns of Overseas Cancer Patients Treated at Tertiary Care Centers in New Delhi. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Prajapati R, Subramanian G, Jain D, Lohia B, Agrawal V, Shankar O, Chaudhary A, Bansal K. Coronary angiographic pattern in young (≤35 years) acute myocardial infarction patients. Indian Heart J 2017. [DOI: 10.1016/j.ihj.2017.09.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Shringirishi M, Mahor A, Gupta R, Prajapati SK, Bansal K, Kesharwani P. Fabrication and characterization of nifedipine loaded β-cyclodextrin nanosponges: An in vitro and in vivo evaluation. J Drug Deliv Sci Technol 2017. [DOI: 10.1016/j.jddst.2017.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bashir I, Bansal K, Chufal K. EP-1041: Evaluation of dysphagia in head and neck cancer patients undergoing Intensity Modulated Radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- K Bansal
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - B Sureka
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S Pargewar
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - A Arora
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
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Affiliation(s)
- B Sureka
- Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - K Bansal
- Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - V Jain
- Department of Renal Transplant and Urology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - A Arora
- Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
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Affiliation(s)
- K Bansal
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - B Sureka
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - V Jain
- Department of Renal Transplant and Urology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - A Arora
- Department of Radiology and Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
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Sureka B, Bansal K, Arora A. Supernumerary horseshoe kidneys. Br J Radiol 2015; 88:20150194. [DOI: 10.1259/bjr.20150194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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45
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Sureka B, Bansal K, Arora A, Jain V. Obstructive uropathy: Is it always urolithiasis? Indian J Nephrol 2015; 25:123-4. [PMID: 25838655 PMCID: PMC4379622 DOI: 10.4103/0971-4065.147372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Tuberculosis still remains a leading infection, causing death
and disability worldwide. We report a patient with isolated
tuberculosis of the talus bone. A 14 year old boy reported
with an eight-month history of swelling and pain in his left
ankle joint. Routine investigations indicated positive
aetiology of tuberculous infection . Surgical curettage of the
talus and, debridement were performed and a below knee
POP cast was applied along with anti TB therapy. After 18
months postoperative , the patient was able to carry out his
daily activities without pain .The ankle and foot are rarely
affected and account for only 1% of all TB infections.
Provisional diagnosis can be made through history and
routine investigations but confirmation by the identification
of the bacillus from the local lesion or by a histopathological
examination of tissue. Talus tuberculosis should be
considered in any long standing inflammatory pathology of
the ankle.
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Affiliation(s)
- A Dahuja
- Department of Orthopedics, Guru Gobind Singh Medical College, Punjab, India
| | - G Dahuja
- Department of Orthopedics, Guru Gobind Singh Medical College, Punjab, India
| | - R Kaur
- Department of Orthopedics, Guru Gobind Singh Medical College, Punjab, India
| | - K Bansal
- Department of Orthopedics, Guru Gobind Singh Medical College, Punjab, India
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Goyal M, Chopra R, Bansal K, Marwaha M. Role of obturators and other feeding interventions in patients with cleft lip and palate: a review. Eur Arch Paediatr Dent 2014; 15:1-9. [PMID: 24425528 DOI: 10.1007/s40368-013-0101-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 11/30/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Newborns with cleft palate have a distorted maxillary arch at birth. Depending upon the type of cleft, infants suffer from a variety of problems, many of which are related to feeding difficulties. Feeding these babies is an immediate concern because there is evidence of delayed growth of children with cleft lip and palate (CLCP) compared to normal infants. Many methods have been devised to overcome these problems, including the use of special bottles, nipples, and initial obturator therapy. REVIEW A Pub Med search was conducted using the following search terms: feeding interventions in cleft lip and palate, feeding plate/obturator in cleft palate. All the relevant articles were studied and the reference list of selected articles was also studied. Effects of different feeding interventions in infants with cleft palate with special emphasis on obturators, based on descriptive reports, expert opinions, and available data from clinical trials was reviewed. RESULTS The combination of search terms generated a list of 74 articles out of which 51 articles were excluded based on analyses of abstracts and full texts. Three additional publications were identified by the manual search. A total of 26 relevant articles were selected which included randomised controlled trials and descriptive studies on feeding interventions and obturators. CONCLUSION A single intervention may not fulfil all feeding requirements of infants with CLCP. Combined use of different feeding interventions such as palatal obturator, Haberman feeder, and breast milk pump and lactation education may successfully meet the feeding needs of both mother and child.
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Affiliation(s)
- M Goyal
- Department of Paedodontics and Preventive Dentistry, SGT Dental College, Hospital and Research Institute, Budhera, 122505, Gurgaon, India
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Bansal K, Singh C, Sandhu B, Sood N, Dandale M. Antemortem diagnosis of rabies from skin by TaqMan real time PCR. INDIAN J ANIM RES 2014. [DOI: 10.5958/0976-0555.2014.00038.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gupta R, Verma S, Bansal K, Mohta A. Thymolipoma in child: a case diagnosed by correlation of ultrasound-guided fine needle aspiration (EUS-FNA) cytology and computed tomography with histological confirmation. Cytopathology 2013; 25:278-9. [PMID: 23902624 DOI: 10.1111/cyt.12087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/26/2022]
Affiliation(s)
- R Gupta
- Department of Pathology, Chacha Nehru Bal Chikitsalaya (Associate Hospital of Maulana Azad Medical College), Delhi, India
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50
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Dandale M, Singh C, Ramneek V, Deka D, Bansal K, Sood N. Sensitivity comparison of nested RT-PCR and TaqMan real time PCR for intravitam diagnosis of rabies in animals from urine samples. Vet World 2013. [DOI: 10.5455/vetworld.2013.189-192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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