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Panigrahi C, Shahin M, Nayak HK, Padhi S, Tripathy BB, Patra S. Gastric inflammatory myofibroblastic tumor in a young child - A case report and literature review. INDIAN J PATHOL MICR 2023; 66:428-430. [PMID: 37077106 DOI: 10.4103/ijpm.ijpm_691_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Affiliation(s)
- Chinmayee Panigrahi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mohammed Shahin
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Hemanta K Nayak
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somanath Padhi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bikasha B Tripathy
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Susama Patra
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Nayak HK, Pattnaik B, Mohakud S, Mitra JK, Krishna EV, Sethi S, Samal SC. Rescue Devascularization in Coronavirus Disease 19 (COVID-19) Induced Early Shunt Thrombosis After Emergency Proximal Spleno-renal Shunt for Extrahepatic Portal Vein Obstruction. J Clin Exp Hepatol 2022; 12:721-722. [PMID: 34226804 PMCID: PMC8241577 DOI: 10.1016/j.jceh.2021.06.020] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hemanta K Nayak
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bramhadatta Pattnaik
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jayanta K Mitra
- Department of Anaesthesiology and Critical Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Edla V Krishna
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Shivam Sethi
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Subash C Samal
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India
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Panigrahi C, Nayak HK, Patra S, Mitra S. Hepatic Follicular Dendritic Cell Sarcoma with Epithelioid Morphology: Histopathologist's Perspective. J Clin Exp Hepatol 2022; 12:677-685. [PMID: 35535111 PMCID: PMC9077179 DOI: 10.1016/j.jceh.2021.06.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022] Open
Abstract
Follicular dendritic cell (FDC) sarcoma is an uncommon tumor of the liver with only 30 previous cases reported in the English literature. Histopathological examination is the gold standard for the diagnosis of FDC sarcoma although the diagnosis is often missed because of its rarity. It usually presents with spindle-cell morphology although epithelioid/biphasic morphology is also well-known. This morphological variation can also pose a diagnostic challenge. We discuss a case of unresectable hepatic FDC sarcoma in an adult male who was diagnosed in core biopsy. We highlight the relevant histomorphological differentials and diagnostic approaches to FDC sarcoma in this anecdote.
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Key Words
- AFP, alpha-fetoprotein
- CT, computed tomography
- E-GIST, epithelioid gastrointestinal stromal tumor
- E-LMS, epithelioid leiomyosarcoma
- E-MPNST, epithelioid malignant peripheral nerve sheath tumor
- EBV, Epstein–Barr virus
- EHE, epithelioid hemangioendothelioma
- FDC, follicular dendritic cell
- HAML, hepatic angiomyolipoma
- HCC, hepatocellular carcinoma
- IPT, inflammatory pseudotumor
- LMP, latent membrane protein
- USG, ultrasonography
- epithelioid
- extranodal
- follicular dendritic cell sarcoma
- histopathology
- liver
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Affiliation(s)
- Chinmayee Panigrahi
- Department of Pathology and Laboratory Medicine, AIIMS, Bhubaneswar, 751019, India
| | - Hemanta K. Nayak
- Department of Gastroenterology, AIIMS, Bhubaneswar, 751019, India
| | - Susama Patra
- Department of Pathology and Laboratory Medicine, AIIMS, Bhubaneswar, 751019, India
| | - Suvradeep Mitra
- Department of Pathology and Laboratory Medicine, AIIMS, Bhubaneswar, 751019, India
- Address for correspondence: Dr Suvradeep Mitra MD, DM (Histopathology), Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Academic Block, 2nd Floor, Bhubaneswar, 751019, India. Tel.: +91 9855663999 (mobile), Fax: +91 6742472215.
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Nayak HK, Kumari N, Mohindra S. Unusual cause of dysphagia. BMJ Case Rep 2021; 14:14/7/e244694. [PMID: 34312143 PMCID: PMC8314744 DOI: 10.1136/bcr-2021-244694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Hemanta K Nayak
- Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Niraj Kumari
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Samir Mohindra
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Nayak HK, Lokesh CR, Mohindra S. Mantle Cell Lymphoma Presenting as Colonic Lymphomatous Polyposis. Clin Gastroenterol Hepatol 2018; 16:e116-e117. [PMID: 30059650 DOI: 10.1016/j.cgh.2017.10.014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/08/2017] [Accepted: 10/15/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Hemanta K Nayak
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - C R Lokesh
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Samir Mohindra
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Ghoshal UC, Karyampudi A, Verma A, Nayak HK, Mohindra S, Morakhia N, Saraswat VA. Perforation following pneumatic dilation of achalasia cardia in a university hospital in northern India: A two-decade experience. Indian J Gastroenterol 2018; 37:347-352. [PMID: 30121890 DOI: 10.1007/s12664-018-0874-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/30/2018] [Indexed: 02/04/2023]
Abstract
Pneumatic dilation (PD) is a cost-effective first-line treatment for achalasia. The most feared complication of PD is esophageal perforation (EP). As data on EP after PD for achalasia are not widely reported, we present the frequency, risk factors, and treatment-outcome of EP. Records of patients undergoing PD for achalasia (January 1995 to September 2015) were retrospectively reviewed. Of 433 patients (age 38 years, 13-88, 57% male), and 521 dilations, 12 were complicated by EP (2.7% of patients and 2.3% of PD). EP occurred in 7 (3.4%), 4 (1.7%), and 1 (4.1%) with use of balloon diameters 30, 35, and 40 mm, respectively. In most (11/12, 92%), EP occurred during the first PD. No risk factor for EP was identified (p = 0.65 for the first dilation vs. > 1 dilation, and 0.75 for balloon size of 30 mm vs. > 30 mm). Seven patients with contrast leak on esophagogram and/or computed tomography scan underwent surgery. One other with contrast leak was successfully treated with a fully covered self-expandable metal stent (FC-SEMS); the remaining four with small leak/pneumomediastinum were managed conservatively. The median duration of hospital stay following perforation was 13 days (7-26) and 8 days (6-10) in surgery and conservative groups, respectively. No mortality was observed in either group. The frequency of EP with PD was 2.3%. Though most EP (92%) occurred during the first dilation, neither the balloon size nor repeated dilations were identified as risk factors. Both surgical and conservative approaches had a favorable outcome in appropriate settings.
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Affiliation(s)
- Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
| | - Arun Karyampudi
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Abhai Verma
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Hemanta K Nayak
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Samir Mohindra
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Nakul Morakhia
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Vivek A Saraswat
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
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Nayak HK, Kumar S, Ghoshal UC, Mohindra S, Mohindra N, Pande G, Saraswat VA. Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients. Journal of Digestive Endoscopy 2017. [DOI: 10.4103/jde.jde_79_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
ABSTRACT
Background: We evaluated short‑ and long‑term results of endoscopic drainage (a minimally invasive nonsurgical treatment) of pancreatic pseudocysts (PPCs) and factors associated with its success at a multilevel teaching hospital in Northern India, as such data are scanty from India. Patients and Methods: Retrospective review of records of consecutive patients undergoing endoscopic drainage of PPC from January 2002 to June 2013 was undertaken. Results: Seventy‑seven patients (56 males), median age 36 years (range, 15–73), underwent endoscopic drainage of PPC with 98% technical success. Pseudocysts drained were symptomatic (duration 11 weeks, range, 8–68), large (volume 582 mL [range, 80–2706]), located in head (n = 32, 46%), body and tail (n = 37, 54%), and infected (n = 39, 49%). Drainage procedures included cystogastrostomy (n = 54, 78%), cystoduodenostomy (n = 9, 13%), transpapillary drainage (n = 2, 3%), and multiple route (n = 4, 6%), with additional endoscopic nasocystic drainage (ENCD) in 41 (59%). Sixty‑nine patients were followed up (median 28 months, range 2–156; other eight lost to follow‑up). Complications (n = 21, 30%) included stent occlusion and migration (13), bleeding (5), perforation (2), and death (1). Endoscopic procedure had to be repeated in 19 patients (28%; 16 for sepsis, 3 for recurrence). The reasons for additional nonendoscopic treatment (n = 8, 12%) included incomplete cyst resolution (3), recurrence (2), bleeding (1), and perforation (2). Overall success rate of endoscopic drainage was 88%. Whereas infected pseudocysts were associated with poorer outcome (odds ratio [OR] 0.016; 95% confidence interval [CI] 0.001–0.037), placement of ENCD led to better results (OR 11.85; 95% CI 1.03–135.95). Conclusion: Endoscopic drainage is safe and effective for PPC.
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Affiliation(s)
- Hemanta K. Nayak
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sandeep Kumar
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Uday C. Ghoshal
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Samir Mohindra
- Departments of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Namita Mohindra
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gaurav Pande
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivek Anand Saraswat
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Nayak HK, Kumar K, Saraswat VA, Pandey G, Mohindra S, Singh A. An Unusual Complication of Pyogenic Liver Abscess. J Clin Exp Hepatol 2016; 6:337-338. [PMID: 28003727 PMCID: PMC5157914 DOI: 10.1016/j.jceh.2016.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 07/12/2016] [Indexed: 12/12/2022] Open
Affiliation(s)
| | | | | | | | - Samir Mohindra
- Address for correspondence: Dr. Samir Mohindra, Additional Professor, Department of Gastroenterology, C Block, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India. Tel.: +91 8004904782.Additional Professor, Department of Gastroenterology, C Block, Sanjay Gandhi Post Graduate Institute of Medical SciencesLucknow226014India
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Affiliation(s)
- Hemanta K Nayak
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
| | - Shankar Mohindra
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
| | - Samir Iqbal
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
| | - Vivek Anand Saraswat
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
| | - Vinita Agarwal
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
| | - Gaurav Pande
- State University of New York Downstate-Kings County Hospital Center, Brooklyn, New York, USA
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Nayak HK, Saraswat VA, Mohindra S, Prasad R, Karyampudi A. Upper Gastrointestinal Bleed Following Percutaneous Liver Abscess Drainage. J Clin Exp Hepatol 2015; 5:349-51. [PMID: 26900278 PMCID: PMC4723642 DOI: 10.1016/j.jceh.2015.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/03/2015] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hemanta K. Nayak
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Vivek A. Saraswat
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Samir Mohindra
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India,Address for correspondence: Samir Mohindra, Associate Professor, Department of Gastroenterology, C Block, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.
| | - Raghunandan Prasad
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Arun Karyampudi
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
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Affiliation(s)
- Hemanta K Nayak
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India
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Kamble NL, Khan NA, Kumar N, Nayak HK, Daga MK. Study of gastro-oesophageal reflux disease in patients with mild-to-moderate chronic obstructive pulmonary disease in India. Respirology 2013; 18:463-7. [PMID: 23062059 DOI: 10.1111/j.1440-1843.2012.02285.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE To study the incidence and pattern of gastro-oesophageal reflux disease (GORD) in patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) using dual-probe 24-h oesophageal pH recording. METHODS This was a prospective study of 50 patients with mild-to-moderate stage COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. A detailed history of illness along with spirometry was done in all patients. In the study group, reflux symptoms were measured using a validated scoring system. All the patients underwent oesophageal manometry and dual-probe 24-h oesophageal pH recording. RESULTS Symptoms of gastro-oesophageal reflux were present in 38 patients. Twenty-four-hour oesophageal pH monitoring revealed pathological reflux in 31 out of 38 symptomatic and 8 out of 12 asymptomatic patients. The overall rate of GORD was 78% in our study. Only distal GORD was observed in 11 (28.9%), and both distal and proximal GORD was observed in 20 (52.6%) out of the 38 symptomatic subjects. In the remaining 12 asymptomatic patients, eight had GORD. Distal GORD was present in six (50%) patients, and two (16.6%) had both distal and proximal GORD in this group. Isolated proximal GORD was not observed in any patient. CONCLUSIONS There is an increased occurrence of GORD in patients with even mild-to-moderate COPD.
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Affiliation(s)
- Nitish L Kamble
- Department of Medicine, Maulana Azad Medical College Department of Biosciences, Jamia Millia Islamia, New Delhi, India
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Nayak HK, Nishant R, Sinha NK, Daga MK. Anaplastic large T-cell lymphoma presenting as an isolated osseous involvement: a case report and review of the literature. BMJ Case Rep 2013; 2013:bcr-2013-009308. [PMID: 23605839 DOI: 10.1136/bcr-2013-009308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This case describes a 50-year-old man with multiple lytic bone lesions involving the skull, pelvis and ribs and associated features of anaemia, hypercalcaemia, azotaemia and subsequently found to be non-Hodgkin's lymphoma of anaplastic large T cell type (ALCL) on biopsy taken from a soft tissue mass in the anterior chest wall as an aetiology. We report this case with an aim to expand our knowledge of isolated osseous involvement in case of non-Hodgkin's lymphoma. This case was unique in the sense of an isolated osseous involvement in ALCL without any organomegaly and lymphadenopathy with a normal bone marrow biopsy finding. So in rare instances, T-cell lymphoma can present with a multiple lytic lesion, anaemia, hypercalcaemia. Although B-cell non-Hodgkin's lymphoma can present with the above manifestation, it is extremely rare for T-cell non-Hodgkin's lymphoma.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, New Delhi, India.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, New Delhi, India.
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Nayak HK, Rajkumar VD, Kumar N, Kar P. Primary hypertrophic osteoarthropathy (incomplete form) in young adults: a case report and review of literature. BMJ Case Rep 2012; 2012:bcr-2012-007745. [PMID: 23242097 DOI: 10.1136/bcr-2012-007745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hypertrophic osteoarthropathy is characterised by digital clubbing and periosteal reaction of long bones. Most cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia and inflammatory bowel diseases. We report a middle-aged man found to have 15-year history of clubbing of the fingers and toes on his routine check-up for dyspepsia. Skiagram of hand joints showed periosteal apposition without any periosteal reaction of long bones. The search for a secondary cause of clubbing remained negative. The primary or idiopathic form is rare and has a good prognosis and has to be differentiated from secondary form. He was eradicated successfully with Pylori kit for his antral predominant Helicobacter-induced gastritis.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, New Delhi, India.
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Nayak HK, Maurya G, Kapoor N, Kar P. Delayed presentation of congenital diaphragmatic hernia presenting with intrathoracic gastric volvulus: a case report and review. BMJ Case Rep 2012. [PMID: 23195824 DOI: 10.1136/bcr-2012-007332] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute gastric volvulus associated with congenital diaphragmatic hernia is an unusual surgical emergency and its presentation in adulthood is extremely rare. Gastric volvulus is an uncommon condition which is difficult to diagnose and treat. This case describes a middle aged man presenting with post-traumatic acute abdomen and finally being diagnosed as a case of gastric volvulus due to congenital diaphragmatic hernia which was till now asymptomatic and undiagnosed. Clinical examination and chest x-ray was suggestive of hiatus hernia. Contrast-enhanced CT of thorax and abdomen revealed hiatus hernia and gastric volvulus. A provisional diagnosis of post-traumatic hiatus hernia with associated gastric volvulus was made and was operated on an emergency basis. Surprisingly, the intraoperative findings revealed significant adhesions near the diaphragm suggestive of congenital diaphragmatic hernia. Hence, a diagnosis of gastric volvulus due to congenital diaphragmatic hernia was made which remained asymptomatic and undiagnosed till adulthood. He responded well to operative management and remained asymptomatic afterwards.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, New Delhi, India.
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Singh N, Nayak HK, Bagchi A, Kar P. Periampullary mass--a rare presentation of poorly differentiated neuroendocrine cancer of duodenum in a young adult: a case report and review of literature. BMJ Case Rep 2012; 2012:bcr-2012-007010. [PMID: 23048000 DOI: 10.1136/bcr-2012-007010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Poorly differentiated neuroendocrine tumour in the periampullary region of the duodenum is a rare entity. This entity usually present in old men. Here we report a periampullary poorly differentiated neuroendocrine cancer (PDEC) of duodenum presenting in a young man with subacute history of jaundice, abdominal pain, pancreatitis and constitutional symptoms. MRI localised the tumour and endoscopy-guided biopsy of the lesion proved the diagnosis. Although palliative surgery and chemotherapy were planned, the patient opted to leave against medical advice.
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Affiliation(s)
- Neha Singh
- Department of Medicine, Maulana Azad Medical College, New Delhi, New Delhi, India
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Nayak HK, Vangipuram DR, Kumar S, Kar P, Gupta A, Kapoor N, Sonika U. Sweet's syndrome in a patient with infective endocarditis: a rare clinical entity. BMJ Case Rep 2012; 2012:bcr.12.2011.5398. [PMID: 22605716 DOI: 10.1136/bcr.12.2011.5398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, has been associated with malignancy, autoimmune disease and collagen vascular disease. The association of infective endocarditis and Sweet's syndrome is rare. The authors report a case of Sweet's syndrome in a patient with infective endocarditis. Infective endocarditis should be excluded in patients of rheumatic heart disease presenting with Sweet's syndrome. Alternatively, Sweet's syndrome should be considered as a differential diagnosis when a patient with infective endocarditis develops skin lesions.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, Newdelhi, India.
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Nayak HK, Vangipuram DR, Sonika U, Kar P, Kumar N, Kapoor N. Mediastinal mass-a rare presentation of desmoplastic small round cell tumour. BMJ Case Rep 2011; 2011:bcr.10.2011.5042. [PMID: 22670008 DOI: 10.1136/bcr.10.2011.5042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Primary mediastinal desmoplastic small round cell cancer is an uncommon tumour usually located in the abdomen and pelvis. Here the authors report an extremely rare case of a young male with a primary desmoplastic small round cell tumour in the anterior and middle mediastinum. The patient had non-specific complaints but an abnormal shadow was seen in a routine chest x-ray. He was diagnosed as having mediastinal mass with few lung parenchymal deposits on CT. Mediastinoscopy and guided biopsy revealed desmoplastic small round cell tumour. Desmoplastic small round cell tumour is a rare and aggressive tumour which rarely involves the mediastinum as a primary site. The nature of the lesion and its prognosis were explained to the patient. He was offered chemotherapy and radiotherapy for the tumour management. He refused treatment and left against medical advice.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, Newdelhi, India.
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Kumar R, Daga MK, Kamble NL, Sothwal A, Singh T, Nayak HK, Raizada N. Rare association of Visceral leishmaniasis with Hodgkin's disease: A case report. Infect Agent Cancer 2011; 6:17. [PMID: 22011565 PMCID: PMC3206818 DOI: 10.1186/1750-9378-6-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 10/20/2011] [Indexed: 11/10/2022] Open
Abstract
We present here a case of young male with complaints of fever and swelling in the neck for eight months. History of progressive weakness associated with weight loss was present. Physical examination revealed pallor, multiple enlarged cervical lymph nodes and hepatosplenomegaly. Investigations showed pancytopenia, hyperglobinemia and Leishman-Donovan bodies on bone marrow aspiration. Serological test confirmed diagnosis of visceral leishmaniasis. However, cervical lymph node aspiration and biopsy were suggestive of Mixed cellularity Hodgkin's disease. This made it a very rare case of Leishmaniasis as an opportunistic infection in a patient of pre-chemotherapy Hodgkin's disease. There was marked improvement in haematological profile and regression of hepatosplenomegaly with Amphotericin B treatment followed by favourable response to chemotherapy. The case emphasizes the suspicion for leishmaniasis as a masquerader and as an opportunistic infection in haematological malignancies.
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Affiliation(s)
- Rakshit Kumar
- Department of Medicine, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
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Nayak HK, Sothwal A, Raizaida N, Daga MK, Agarwal AK, Durga G. A rare case of non-insulinoma pancreatic hypoglycaemia syndrome (niphs) in an adult due to localised islet cell hyperplasia-successfully managed by enucleation. BMJ Case Rep 2011; 2011:bcr0720114554. [PMID: 22675010 PMCID: PMC3207758 DOI: 10.1136/bcr.07.2011.4554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Persistent hyperinsulinemic hypoglycaemia is caused most commonly by an insulinoma in adults or by nesidioblastosis in neonates. In adults, localised islet cell hyperplasia is a rare disorder characterised by localised proliferation of islet cells. The authors present the case of a previously healthy non-obese middle aged female with new-onset severe hypoglycaemia. Laboratory findings confirmed a case of hyperinsulinemic hypoglycaemia. Endoscopic ultrasonography, intra-arterial calcium stimulation test and intraoperative ultrasonography showed a lesion in the uncinate process that was enucleated. Rest of the pancreas was normal. Histological examination and immunostaining of the resected tissue revealed pancreatic tissue with maintained acinar pattern consistent with diagnosis of localised islet cell hyperplasia. The patient did not have further episodes of hypoglycaemia following the procedure. Localised islet cell hyperplasia with such a very high insulin level is exceedingly rare in adult populations and not reported in literature. This diagnosis cannot be easily made through routine diagnostic laboratory or radiological procedures and likely requires a histological diagnosis. Management of this rare entity is by enucleation.
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Affiliation(s)
- Hemanta K Nayak
- Department of Medicine, Maulana Azad Medical College, NewDelhi, India.
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Daga MK, Sinha N, Mahapatra HS, Kumar R, Lalmalsawma R, Nayak HK, Raizada N. Paraphenylene diamine poisoning. J Indian Med Assoc 2011; 109:49. [PMID: 21894627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Parthiban R, Shanmugam S, Velu V, Nandakumar S, Dhevahi E, Thangaraj K, Nayak HK, Gupte MD, Thyagarajan SP. Transmission of hepatitis C virus infection from asymptomatic mother to child in southern India. Int J Infect Dis 2009; 13:e394-400. [PMID: 19376736 DOI: 10.1016/j.ijid.2009.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Accepted: 01/23/2009] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Little information is available on the mother-to-child transmission of hepatitis C virus (HCV) in India, and no interventions to decrease transmission rates have been identified. Hence, we performed a long-term prospective study in infants born to HCV-positive mothers, with the aim of evaluating vertical transmission of HCV and correlated risks factors. METHODS Three thousand one hundred and fifteen healthy asymptomatic pregnant women were included in the study. We used third-generation (Murex anti-HCV) ELISA and HCV RNA reverse transcription PCR (RT-PCR) for screening, and the commercial line probe assay (Inno-LiPA) and direct sequencing HCV genotyping assays were performed to confirm the transmitted HCV genotypes. RESULTS Of the total 3115 healthy asymptomatic pregnant women, 18 (0.6%) were positive for anti-HCV. Of the 18 anti-HCV-positive women, eight (44.4%) were positive for HCV RNA RT-PCR. HCV transmission was observed in two of the eight babies born to eight HCV RNA-positive mothers who were followed up for 12 months. HCV genotyping of the mother/child pairs revealed the persistent presence of mixed genotypes 1a and 4 throughout the follow-up period. None of the non-viremic (HCV RNA-negative) mothers transmitted HCV infection to their baby. In our study approximately 25% of vertical/perinatal transmission of HCV was observed among HCV RNA-positive antenatal women. CONCLUSIONS This study is of importance as it is the first report from India of a successful attempt to analyze the rate of vertical/perinatal transmission of HCV from infected mothers to their children by a prospective longitudinal follow-up study, and to characterize the pattern of genotype(s) of HCV present in the infected mother/baby pairs, so as to confirm the source of HCV acquired by the newborn babies.
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Affiliation(s)
- Rudrapathy Parthiban
- Department of Microbiology, Dr ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Chennai, India
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Nayak HK, Das HK, Mahanta J, Srivastava VK. An outbreak of acute diarrheal diseases caused by E. coli in a tea garden of upper Assam. J Commun Dis 1996; 28:209-11. [PMID: 8973023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- H K Nayak
- Regional Medical Research Centre, N.E. Region Indian Council of Medical Research, Assam
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