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Article: Prehospital care and interfacility transfer of trauma patients before reaching the emergency of a level-1 trauma care center.

Hansda, Upendra / Mishra, Tushar S / Topno, Nitish / Sahoo, Sangeeta / Mohan, Sreshtaa / Chakola, Sebastian

Journal of family medicine and primary care

2024 Volume 13, Issue 2, Page(s) 656–659

Abstract: Background: Management of trauma patients includes prevention, prehospital care, appropriate resuscitation at a hospital, definitive treatment, and rehabilitation. Timely and adequate care for a trauma patient is paramount, which can dramatically impact ...

Abstract	Background: Management of trauma patients includes prevention, prehospital care, appropriate resuscitation at a hospital, definitive treatment, and rehabilitation. Timely and adequate care for a trauma patient is paramount, which can dramatically impact survival. This study was planned to assess the proportion of patients who failed to receive adequate prehospital care before reaching our institute. Materials and methods: A retrospective study was conducted in the trauma and emergency department of a level-1 trauma center in eastern India from February to April 2022. The demographic profile, vital parameters, injury, mode of transport, travel duration, referring hospital, and any interventions as per airway/breathing/circulation/hypothermia were collected. Results: The records of a hundred-two patients who were brought to the trauma and emergency department in the study period were reviewed. Road traffic accident involving two wheelers was the leading cause of injury. Eighty-three percent of the patients were referred from other health centers, of which 49 were referred from district headquarters hospitals. Only three patients out of 14 had been provided with an oropharyngeal airway for whom endotracheal intubation was indicated. Only one among the 41 patients needing Philadelphia collar actually received. Sixteen patients were provided supplemental oxygen out of the 35 for whom it was indicated. Out of 68 patients in whom intravenous cannulation and fluid administration were indicated, only 35 patients had received it. Out of 31 patients with fractures, none were provided immobilization. Conclusion: The care of the trauma patients with respect to airway, breathing, circulation, and fracture immobilization was found to be grossly inadequate, emphasizing the need of structured and protocol based prehospital trauma care.
Language	English
Publishing date	2024-03-06
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_1271_23
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Article ; Online: Use of Technology to Improve the Adherence to Surgical Safety Checklists in the Operating Room.

Pati, Akash Bihari / Mishra, Tushar S / Chappity, Preetam / Venkateshan, Mahalingam / Pillai, Jawahar S K

Joint Commission journal on quality and patient safety

2023 Volume 49, Issue 10, Page(s) 572–576

Abstract: Background: Although checklists can improve safety in the operating room (OR), compliance with their use is variable. Use of a forcing function, a principle of human factors engineering, has not been reported earlier as a method of increasing checklist ... ...

Abstract	Background: Although checklists can improve safety in the operating room (OR), compliance with their use is variable. Use of a forcing function, a principle of human factors engineering, has not been reported earlier as a method of increasing checklist use. The authors conducted this study to determine the feasibility and effects of introducing a forcing function on OR surgical safety checklist implementation and adherence. Methods: The authors developed and introduced the use of an electronic version of the surgical safety checklist on an Android application, provided on a personal device available in the OR. This application was linked by Bluetooth to electrocautery equipment, which could not be started before the electronic checklist was completed on the screen of the personal device. In the same OR, retrospective data from use of the traditional (paper-based) checklist were compared with data from the new electronic checklist for frequency of use, and completeness (percentage of all checklist items completed) at three stages of the surgical process-sign-in, time-out, and sign-out. Results: The frequency of use was 100.0% for the electronic checklist, compared with 97.9% for the traditional checklist. The frequency of completeness was 27.1% for the traditional vs. 100.0% for the electronic (p < 0.001).The manual checklist's sign-out component was completed only 37.0% of the time. Conclusion: Although checklist use in some form was already high with the traditional checklist, completion rate was low and significantly increased with the use of the electronic checklist with a forcing function.
MeSH term(s)	Humans ; Operating Rooms ; Checklist/methods ; Retrospective Studies ; Patient Safety ; Technology
Language	English
Publishing date	2023-04-22
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1189890-2
ISSN	1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
ISSN (online)	1938-131X ; 1549-425X
ISSN	1553-7250 ; 1070-3241 ; 1549-3741
DOI	10.1016/j.jcjq.2023.04.005
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Article: Lithotomy versus prone position for perianal surgery: a randomized controlled trial.

Kumar, Pankaj / Mishra, Tushar S / Sarthak, Siddhant / Sasmal, Prakash Kumar

Annals of coloproctology

2021 Volume 38, Issue 2, Page(s) 117–123

Abstract: Purpose: Studies objectively comparing lithotomy and prone positions regarding surgeon comfort, ergonomics, patient comfort, and position related complications are scarce.: Methods: The patients posted for surgery of either fistula in ano, ... ...

Abstract	Purpose: Studies objectively comparing lithotomy and prone positions regarding surgeon comfort, ergonomics, patient comfort, and position related complications are scarce. Methods: The patients posted for surgery of either fistula in ano, hemorrhoids, or were included in this study. Subjective Mental Effort Questionnaire (SMEQ) and Local Experienced Discomfort (LED) scale were used to score the level of mental and physical stress among the operating surgeon, assistants, and the scrub nurse. Other parameters studied were the exposure of the operative site, patient comfort level, and position-related complications. Results: Thirty patients were operated in each position. Mean±standard deviation of jackknife prone vs. lithotomy surgeon SMEQ score (15.6±10.4 vs. 107.0±11.5, P<0.05) and LED score (1.8±1.5 vs. 6.7±0.5, P<0.05) were found to be statistically significant. Prone vs. lithotomy assistant SMEQ score (29.1±13.1 vs. 100.6±8.7, P<0.05) and LED score (4.6±1.1 vs. 7.4±0.8, P<0.05) were also found to be statistically significant. SMEQ (10.0±0.0 vs. 20.6±2.5, P<0.05) and LED scores (1.1±0.3 vs. 3.3±0.5, P<0.05) of scrub nurses and LED scores (2.5±0.5 vs. 6.3±0.7, P<0.05) of patients were also statistically significant. Exposure of the operative site was significantly better in the prone position (5.0 vs. 2.1, P<0.05). Conclusion: Significantly better SMEQ, LED, and exposure score suggests the superiority of jackknife prone position over the lithotomy in terms of significantly less mental and physical stress to the operating surgeon, assistant, and scrub nurse; better ergonomics, and excellent exposure.
Language	English
Publishing date	2021-06-07
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2020.12.16
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Article ; Online: Ligation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for High-Type Fistula in Ano: A Randomized Controlled Trial.

Kumar, Pankaj / Sarthak, Siddhant / Singh, Pradeep K / Mishra, Tushar S / Sasmal, Prakash K

Journal of the American College of Surgeons

2022 Volume 236, Issue 1, Page(s) 27–35

Abstract: Background: This study aimed to compare the postoperative outcomes and success rate of the endorectal advancement flap and ligation of intersphincteric fistulous tract (LIFT) in high-type fistula in ano.: Study design: This randomized control trial ... ...

Abstract	Background: This study aimed to compare the postoperative outcomes and success rate of the endorectal advancement flap and ligation of intersphincteric fistulous tract (LIFT) in high-type fistula in ano. Study design: This randomized control trial included patients with high-type fistula in ano of cryptoglandular origin. The primary endpoint was complete fistula healing at the end of 6 months. However, the patients were followed up for 2 years. Other parameters studied were perioperative complications, duration of surgery, postoperative pain, hospital stay in hours, continence, and quality of life at 6 months. Results: A total of 84 patients were recruited (42 in each group). The healing rate in the LIFT arm was better than that in the endorectal advancement flap arm (76.2.% vs 54.7%, p = 0.039). Four patients in the endorectal advancement flap group and two in the LIFT group had flatus incontinence at the end of 6 months, but all were continent at 2 years. At the end of the first week, the Visual Analog Scale score and quality of life at 6 months were better in the LIFT arm (3.7 ± 1.16 vs 4.7 ± 0.81 and 0.7 vs 0.6, p < 0.05). The mean duration of surgery was significantly less in the LIFT group (46.43 ± 9.32 vs 89.29 ± 10.90 minutes). None had any postoperative complications, and >80% were discharged within 24 hours. Conclusions: The shorter operative duration, better quality of life at 6 months, and higher healing rate make LIFT a superior treatment option for high fistula in ano. However, studies with a large sample size will be needed to verify these results.
MeSH term(s)	Humans ; Quality of Life ; Rectal Fistula/surgery ; Rectal Fistula/complications ; Ligation/methods ; Surgical Flaps ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Treatment Outcome ; Recurrence ; Anal Canal/surgery ; Fecal Incontinence/etiology
Language	English
Publishing date	2022-12-15
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1097/XCS.0000000000000441
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Article ; Online: Enhancer of Zeste Homolog 2 (EZH2) in Malignant Progression of Gallbladder Carcinoma.

Behera, Gayatri / Mitra, Suvradeep / Mishra, Tushar S / Purkait, Suvendu

Journal of gastrointestinal cancer

2020 Volume 52, Issue 3, Page(s) 1029–1034

Abstract: Purpose: Data related to the role of epigenetic modifications in gallbladder carcinoma (GBC) is limited. We intended to assess the role of crucial epigenetic modifiers pertaining to histone modification and DNA-methylation system in gallbladder ... ...

Abstract	Purpose: Data related to the role of epigenetic modifications in gallbladder carcinoma (GBC) is limited. We intended to assess the role of crucial epigenetic modifiers pertaining to histone modification and DNA-methylation system in gallbladder carcinogenesis. Methods: The expression of EZH2, H3K27me3, and DNA methyltransferases (DNMTs) was analyzed by immunohistochemistry in cases of GBC (n = 39), gallbladder dysplasia (GBD, n = 12), and benign mucosa (BM, n = 16). A semi-quantitative scoring system was used for assessing the immunohistochemical expression. Results: The expression of EZH2 was significantly higher in cases of GBC than GBD (p value 0.001). The cases of BM were negative. Its expression was also higher in poorly differentiated tumors and positively correlated with the proliferative activity (MIB-1 labeling index) (p value 0.03 and 0.01, respectively). There was no significant difference in the expression levels of H3K27me3, DNMT-1, and DNMT-3B among GBC, GBD, and BM cases. Although GBC cases with strong EZH2 expression showed a shorter overall survival, the difference was not statistically significant. Conclusion: This study highlights the crucial role of the key epigenetic regulators EZH2 in the pathobiology and evolution of gallbladder carcinogenesis. Given the reversibility of epigenetic alterations, EZH2 may be a novel therapeutic target for gallbladder carcinogenesis.
MeSH term(s)	Adenocarcinoma ; Aged ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; DNA Methylation ; Enhancer of Zeste Homolog 2 Protein/analysis ; Enhancer of Zeste Homolog 2 Protein/metabolism ; Epigenesis, Genetic ; Female ; Gallbladder Diseases ; Gallbladder Neoplasms/genetics ; Gallbladder Neoplasms/mortality ; Gallbladder Neoplasms/pathology ; Histones/genetics ; Humans ; India/epidemiology ; Male ; Middle Aged ; Retrospective Studies
Chemical Substances	Biomarkers, Tumor ; Histones ; histone H3 trimethyl Lys4 ; EZH2 protein, human (EC 2.1.1.43) ; Enhancer of Zeste Homolog 2 Protein (EC 2.1.1.43)
Language	English
Publishing date	2020-10-14
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2452514-5
ISSN	1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
ISSN (online)	1941-6636 ; 1559-0739
ISSN	1941-6628 ; 1537-3649
DOI	10.1007/s12029-020-00536-3
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Article ; Online: Transmesenteric Internal Abdominal Hernia: Multi-detector row computed tomography findings.

Mohakud, Sudipta / Naik, Suprava / Deep, Nerbadyswari / Singh, Arshdeep / Mishra, Tushar S / Sinha, Mithilesh

Sultan Qaboos University medical journal

2021 Volume 21, Issue 3, Page(s) 502–503

MeSH term(s)	Hernia, Abdominal/diagnostic imaging ; Hernia, Abdominal/surgery ; Humans ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2021-08-29
Publishing country	Oman
Document type	Journal Article
ZDB-ID	2650196-X
ISSN	2075-0528 ; 2075-0528
ISSN (online)	2075-0528
ISSN	2075-0528
DOI	10.18295/squmj.4.2021.025
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Article ; Online: Squamous Metaplasia in a Borderline Phyllodes Tumor-an Undocumented Histological Finding in Male Breast: Report of a Case and Review of Literature.

Panigrahi, Chinmayee / Jha, Shilpy / Kumar, Pankaj / Mishra, Tushar S / Sasmal, Prakash K / Adhya, Amit K

International journal of surgical pathology

2021 Volume 30, Issue 1, Page(s) 106–113

Abstract: Phyllodes tumor is a paradigm of fibroepithelial neoplasm that accounts for <1% of the breast neoplastic lesions usually detected in females and uncommonly in the male breast. The World Health Organization classifies the tumor into benign, borderline, ... ...

Abstract	Phyllodes tumor is a paradigm of fibroepithelial neoplasm that accounts for <1% of the breast neoplastic lesions usually detected in females and uncommonly in the male breast. The World Health Organization classifies the tumor into benign, borderline, and malignant based on the predefined morphological criteria. Squamous differentiation in phyllodes tumor is epithelial metaplasia, which has been occasionally documented in English literature. We report the first undocumented case of a recurrent borderline phyllodes tumor with cystic squamous metaplastic change in a 32-year-old male patient. The histology was that of a fibroepithelial neoplasm with the typical leaf-like projections and cystic spaces lined by squamous epithelium containing keratin debris. The purpose of presenting this case is to elucidate the pathogenesis and discuss other malignant and benign breast lesions that may be included in the differential diagnosis when evaluating a breast lesion with squamous metaplasia, particularly in the context of fine-needle aspirates.
MeSH term(s)	Adult ; Breast Neoplasms, Male/diagnosis ; Breast Neoplasms, Male/pathology ; Humans ; Male ; Phyllodes Tumor/diagnosis ; Phyllodes Tumor/pathology
Language	English
Publishing date	2021-06-03
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1336393-1
ISSN	1940-2465 ; 1066-8969
ISSN (online)	1940-2465
ISSN	1066-8969
DOI	10.1177/10668969211022017
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Article: Basidiobolomycosis of Right Colon Mimicking as Carcinoma of Colon.

Vs, Vikram / Hallur, Vinay / Samal, Swagatika / Chouhan, Mohd Imran / Bhat, Sunil Jee / Kumar, Pankaj / Mishra, Tushar S

ACG case reports journal

2021 Volume 8, Issue 5, Page(s) e00573

Abstract: Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection with limited geographic distribution. However, the incidence of GIB has shown an increasing trend because of globalization and frequent traveling. GIB is commonly seen to mimic ... ...

Abstract	Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection with limited geographic distribution. However, the incidence of GIB has shown an increasing trend because of globalization and frequent traveling. GIB is commonly seen to mimic gastrointestinal malignancy and other diseases such as intestinal tuberculosis and inflammatory bowel disease. Tissue diagnosis is considered to be the gold standard for differentiating these mycotic lesions from tuberculosis and malignancy with confirmation of species performed by culture or polymerase chain reaction. The diagnosis of GIB should be conjectured in patients with suspicion of malignancy, with an inconclusive biopsy. It seems prudent to proceed with radical excision of mass early because both colonic malignancy and GIB have high mortality if untreated.
Language	English
Publishing date	2021-05-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000573
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Article: Impact of personal protective equipment on patient safety and health care workers.

Kumar, Pankaj / Jain, Mantu / Amirthavaali, G / Mishra, Tushar S / Sasmal, Prakash K / Lubaib, K P / Gond, Preeti K / Sarthak, Siddhanth

Medical journal, Armed Forces India

2021 Volume 79, Issue 5, Page(s) 531–538

Abstract: Background: The study aims to assess the effect of personal protective equipment (PPE) on the physical and psychological well-being of health care workers (HCWs) and its impact on patient safety.: Methods: After ethical approval, a 14-point ... ...

Abstract	Background: The study aims to assess the effect of personal protective equipment (PPE) on the physical and psychological well-being of health care workers (HCWs) and its impact on patient safety. Methods: After ethical approval, a 14-point questionnaire was circulated offline and online among the HCWs of ours institute, who were involved in performing invasive procedures while wearing a PPE. The responses were analysed using the SPSS software version 26. Results: Of 198 responses, the mean duration of PPE use was 4.6 ± 1.52 h. Seventy percent of respondents suggested <4 h of continuous use of PPE. Seventy-seven percent found difficulties during the procedures while wearing PPE and agreed to errors while performing a procedure. Poor visibility (95.5%), fogging (84.9%), communication difficulty (75.3%), sweating (74.2%), posture-related discomfort (56.1%) and poor concentration (51%) were major causes. Anxiety (39.9%) and fear of spreading an infection to the family (42.9%) were major psychological effects. Eighty percent of HCWs raised concern over the quality of PPE, N95 mask and eye protector. The HCWs felt the need to improve the quality of PPEs, use extra padding around the ears, sealing the N95 mask with adhesive tape, besides using sign language for communication for more safety. Fifty percent graded the procedure-related difficulty level >6 on a Likert scale of 1-10. Conclusion: PPE-related discomfort is common among the HCWs and could contribute to errors during an invasive procedure. Efforts to alleviate the physical and psychological well-being of the HCWs will be essential for reducing procedural error while wearing a PPE.
Language	English
Publishing date	2021-10-19
Publishing country	India
Document type	Journal Article
ZDB-ID	196342-9
ISSN	0377-1237
ISSN	0377-1237
DOI	10.1016/j.mjafi.2021.07.004
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Article: Malignant Extra-Gastrointestinal Stromal Tumor of the Mesentery.

Sasmal, Prakash K / Sharma, Rakesh / Patra, Susama / Mishra, Tushar S / Mishra, Pritinanda / Rout, Bikram

Surgery journal (New York, N.Y.)

2019 Volume 5, Issue 3, Page(s) e65–e68

Abstract: Gastrointestinal stromal tumors (GISTs), the commonest mesenchymal tumors of gastrointestinal tract are often described to take origin from the interstitial cells of Cajal (ICC) or its precursor cells. Rarely these tumors do arise in structures other ... ...

Abstract	Gastrointestinal stromal tumors (GISTs), the commonest mesenchymal tumors of gastrointestinal tract are often described to take origin from the interstitial cells of Cajal (ICC) or its precursor cells. Rarely these tumors do arise in structures other than the alimentary tract like omentum, mesentery, retroperitoneum, etc., of varying malignant potential and are known as extra-gastrointestinal stromal tumors (eGISTs). This is a case report of a 70-year-old female with multicentric malignant eGISTs arising in the mesentery of ileum. On laparotomy, a large mass of 20 × 15 cm was found in the small bowel mesentery without involvement of the adjacent ileum, with multiple other small nodules resembling lymph nodes, present adjacent to it. Histopathological study of the excised lump, confirmed the mass to be malignant eGIST without involvement of the adjacent ileum, with cluster differentiation (CD)117 positive and of high-risk stratification. The mesenteric nodule was confirmed on histopathology to be malignant eGIST, similar to that of that of the primary, without any lymphoid tissue. Adjuvant imatinib mesylate treatment was started immediately postoperation with the patient doing well at 1 year of follow-up. We report this case, due to the rare occurrence of multifocal malignant eGISTS of small bowel mesentery, which is yet to be reported. The existing literature is unclear regarding the clinicopathology and management of multifocal malignant stromal tumors of the mesentery.
Language	English
Publishing date	2019-08-01
Publishing country	United States
Document type	Case Reports
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0039-1693040
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