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  1. Article ; Online: True mesothelial cyst of the adrenal gland: its clinical profile and management.

    Saini, Vikram / Garg, Richa / Kataria, Kamal / Nelson, Thirugnanasambandam

    BMJ case reports

    2024  Volume 17, Issue 2

    Abstract: The incidence of adrenal cysts is 0.06% and only 9% of these are true mesothelial cysts. Here, we present a case of a true mesothelial cyst together with a review of the literature. A female in her 30s presented to the surgical outpatient department ... ...

    Abstract The incidence of adrenal cysts is 0.06% and only 9% of these are true mesothelial cysts. Here, we present a case of a true mesothelial cyst together with a review of the literature. A female in her 30s presented to the surgical outpatient department complaining of right flank pain. Her contrast-enhanced CT scan revealed a 7.5×6.5×4.5 cm right adrenal gland cyst. The patient underwent a laparoscopic right adrenalectomy. Immunohistopathology revealed the cyst to be mesothelial in nature. The majority of true mesothelial adrenal cysts are benign, unilateral and more common in women. Any adrenal cyst diagnosed as a functional lesion or one that may be malignant or with a diameter of 5 cm or greater requires surgical care whereas smaller lesions can be managed conservatively. Laparoscopic adrenalectomy for an adrenal cyst of diameter greater than 6 cm is a safe and feasible procedure in expert hands if there is no invasion of surrounding tissue.
    MeSH term(s) Humans ; Female ; Adrenal Gland Diseases/diagnostic imaging ; Adrenal Gland Diseases/surgery ; Adrenal Glands/diagnostic imaging ; Adrenal Glands/surgery ; Adrenal Glands/pathology ; Cysts/diagnostic imaging ; Cysts/surgery ; Adrenal Gland Neoplasms/surgery ; Adrenalectomy/methods ; Laparoscopy
    Language English
    Publishing date 2024-02-23
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2023-258485
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Analysis of Thyroid Imaging Reporting and Data System Criteria and Its Correlation With the Pathological Results.

    Kallepalli, Vineel Sai Deepak / Nelson, Thirugnanasambandam / Sanniyasi, Saravanan

    Cureus

    2023  Volume 15, Issue 6, Page(s) e40117

    Abstract: Introduction Thyroid nodules are frequently encountered and may be discovered roughly in around 4-8% of individuals by clinical palpation. Aim The present study aims to analyze the Thyroid Imaging Reporting and Data Systems (TIRADS) classification and ... ...

    Abstract Introduction Thyroid nodules are frequently encountered and may be discovered roughly in around 4-8% of individuals by clinical palpation. Aim The present study aims to analyze the Thyroid Imaging Reporting and Data Systems (TIRADS) classification and assess the validity of each criterion in predicting malignancy. Methods A prospective observational study was conducted at Sri Ramachandra Institute of Higher Education and Research from June 2020 to October 2021. Fifty patients who presented to the outpatient clinic with thyroid swelling got an ultrasound (USG) neck performed followed by either fine-needle aspiration cytology (FNAC) or thyroidectomy. They were included in the study and informed consent was obtained from all patients. Results Among 50 patients considered for the study, 36 were females. The mean age for malignant patients is 46 years with a standard deviation (SD) of 15, and for benign lesions is 47 years with an SD of 1. Most of the patients were TIRADS 4, which has a 56.2% risk of malignancy. The pathological results show a significant difference in ACR (American College of Radiology) TIRADS and echogenic foci between FNAC. The present study's solid composition showed a sensitivity of 25% and specificity of 75%, with an odds ratio of 0.90 in picking up malignant nodules. The shape of a nodule taller than wider, a malignant feature, showed a specificity of 92.3%. Punctate echogenic foci showed a sensitivity of 50% and specificity of 76.9% with a statistical significance of p-value 0.048. Conclusion TIRADS scoring avoids unessential invasive techniques for lower TIRADS scores. Certain criteria are more specific in recognizing malignant nodules. Proportional priority shall be given to certain criteria over others, and not all criteria should be considered.
    Language English
    Publishing date 2023-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.40117
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A study on prevalence, profile, and risk factors of developing fungal infection in patients with diabetic foot ulcer.

    Sk, Azharuddin / Vijayakumar, Chellappa / Nelson, Thirugnanasambandam / Balasubramanian, Gopal / Kumar, Nagarajan Raj / Singh, Rakesh

    Wound management & prevention

    2023  Volume 69, Issue 3, Page(s) 11–17

    Abstract: Background: Many chronic nonhealing diabetic foot ulcers (DFUs) with increased rates of amputation are frequently associated with fungal infections.: Purpose: To evaluate the prevalence, profile, and risk factors of developing a fungal infection in ... ...

    Abstract Background: Many chronic nonhealing diabetic foot ulcers (DFUs) with increased rates of amputation are frequently associated with fungal infections.
    Purpose: To evaluate the prevalence, profile, and risk factors of developing a fungal infection in patients with DFU.
    Methods: This prospective observational study was carried out from October 2018 to July 2020. All adult patients with DFUs admitted to the surgery ward were recruited. Patients on antifungal therapy or who received such therapy within 6 weeks prior to admission were excluded. Three deep tissue samples were sent for bacterial culture, fungal culture, and histopathological examination of fungal elements.
    Results: A total of 251 patients were enrolled in the study. Of the 23.3% of patients with positive fungal growth (n = 47/202), 2% (n = 4/202) had pure fungal growth and 21.3% (n = 43/202) had mixed growth with bacteria in their ulcers (ie, non-contaminated samples). A significant association was found between wound grade (P = .027), ulcer duration (P = .028), and positive fungal growth in DFUs.
    Conclusions: In this study, the prevalence of fungal infection in DFUs was 23.3%; Candida tropicalis (27.08%) was the most common isolate, followed by C. albicans (20.83%). The rate of fungal infections was high in patients with mild diabetic foot infection or DFU of 7 to 14 days' duration.
    MeSH term(s) Adult ; Humans ; Diabetes Mellitus ; Diabetic Foot/epidemiology ; Diabetic Foot/microbiology ; Mycoses/epidemiology ; Mycoses/microbiology ; Prevalence ; Risk Factors
    Language English
    Publishing date 2023-12-04
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 2964376-4
    ISSN 2640-5245 ; 2640-5237
    ISSN (online) 2640-5245
    ISSN 2640-5237
    DOI 10.25270/wmp.22076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3333: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Negative Pressure Wound Therapy Compared to Petrolatum Gauze and a Bogota Bag to Manage Postoperative Midline Abdominal Wound Dehiscence: A Pilot, Nonrandomized Controlled Trial.

    Chandrasekhar, Vihari / Sureshkumar, Sathasivam / Manwar, Ali S / Elamurugan, T P / Nelson, Thirugnanasambandam / Anandhi, Amaranathan / Palanivel, Chinnakali

    Wound management & prevention

    2020  Volume 66, Issue 5, Page(s) 38–45

    Abstract: Treating postoperative abdominal wound dehiscence following abdominal surgery using negative pressure wound therapy (NPWT) has shown promising results.: Purpose: A study was conducted to evaluate the efficacy of NPWT for fascial closure/cutaneous ... ...

    Abstract Treating postoperative abdominal wound dehiscence following abdominal surgery using negative pressure wound therapy (NPWT) has shown promising results.
    Purpose: A study was conducted to evaluate the efficacy of NPWT for fascial closure/cutaneous cover compared to non-NPWT treatment using petrolatum gauze and a Bogota bag in patients with postoperative laparotomy wound dehiscence.
    Methods: A single center, prospective, nonrandomized pilot study was conducted. Using convenience sampling methods, consecutive patients on 6 different surgical units who were at least 18 years of age and who developed postoperative abdominal wound dehiscence following elective and emergency laparotomy from January 2017 to December 2018 were recruited. NPWT dressing with polyvinyl white foam sponge or loosely packed, saline-soaked petrolatum gauze followed by Bogota bag application were used and compared. Baseline patient demographics and history were collected, and patients were followed for an average of 6 months after surgery. Number of days until first signs of granulation tissue appearance, time until complete granulation tissue cover/fascial surgical closure, and hospital discharge were compared. Categorical variables (gender, comorbidities, presence or absence of stoma, exposure to prior radiotherapy) were expressed as proportions and analyzed using chi-squared test or Fischer's exact test. Continuous variables such as age, body mass index, albumin, postoperative hospital stay, and number of days required for decision for fascial closure were expressed as Mean ± standard deviation and analyzed using an independent t test or Mann Whitney U test based on whether the data followed normal distribution. Postoperative day of wound dehiscence, the number of days for the appearance of granulation tissue, and the number of NPWT placements required also were assessed using Mean ± standard deviation and analyzed using an independent t test. A P value <.05 was considered significant.
    Results: Sixty (60) patients were included, but 4 in NPWT group and 10 in the non-NPWT group could not complete the study, leaving 26 patients in NPWT group and 20 patients in non-NPWT group. Demographic and surgical variables were not significantly different. Patients in both groups achieved complete wound coverage by surgical closure or healing by secondary intention. Days until first signs of granulation tissue (2.92 vs. 6.65; P <.001), number of days until fascial closure (15.50 vs. 29.50; P <.001), and length of postoperative hospital stay (24.30 vs. 37.90; P <.001) were significantly less in NPWT group. Two (2) patients (7.6%) in the NPWT developed a fistula during the 6-month follow-up period. No fistulas developed in the control group, and no intra-abdominal abscesses, ventral hernias, or wound dehiscence were reported in either group.
    Conclusion: Time until first signs of granulation tissue appearance and complete granulation tissue coverage was significantly shorter in the NPWT group, but time until definitive closure was not evaluated. Randomized, controlled clinical studies to compare definitive time to wound closure and long-term follow up to evaluate long-term complication rates, including the risk of developing fistulas, are warranted.
    MeSH term(s) Abdominal Wound Closure Techniques/instrumentation ; Abdominal Wound Closure Techniques/standards ; Adult ; Bandages/standards ; Female ; Humans ; India ; Male ; Middle Aged ; Negative-Pressure Wound Therapy/instrumentation ; Negative-Pressure Wound Therapy/methods ; Negative-Pressure Wound Therapy/standards ; Petrolatum/therapeutic use ; Pilot Projects ; Postoperative Complications/prevention & control ; Postoperative Complications/therapy ; Prospective Studies
    Chemical Substances Petrolatum (8009-03-8)
    Language English
    Publishing date 2020-05-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2964376-4
    ISSN 2640-5245 ; 2640-5237
    ISSN (online) 2640-5245
    ISSN 2640-5237
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3333: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  5. Article ; Online: Early versus conventional stoma closure following bowel surgery: A randomized controlled trial.

    Nelson, Thirugnanasambandam / Pranavi, Amuda R / Sureshkumar, Sathasivam / Sreenath, Gubbi S / Kate, Vikram

    Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

    2018  Volume 24, Issue 1, Page(s) 52–58

    Abstract: Background/aim: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH).: ... ...

    Abstract Background/aim: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH).
    Patients and methods: This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included. The rate of complications (medical and surgical) following early and conventional stoma closure was assessed. Health-related QoL and LoH were also measured.
    Results: One hundred patients were included, with 50 cases in each group. Postoperative complications including laparostoma (6% vs. 2%;P = 0.307), wound infection (32% vs. 18%; P = 0.106), intra-abdominal collection (14% vs. 18%; P = 0.585), anastomotic leak (4%vs. 8%;P = 0.400), and medical complications were comparable (22% vs. 32%;P = 0.257). The length of hospital stay, overall mortality and morbidity (64% vs. 44%; P = 0.05) were similar across the two groups. There was a significant reduction in the cost towards stoma care (96% vs. 2%; P = 0.001) in the early stoma closure group. Patients in the early stoma closure group also had a significantly better QoL.
    Conclusion: Early stoma closure does not carry an increased risk of postoperative complications, reduces cost towards stoma care, and leads to better a QoL.
    MeSH term(s) Female ; Humans ; Intestines/surgery ; Length of Stay ; Male ; Postoperative Complications/epidemiology ; Prospective Studies ; Quality of Life/psychology ; Surgical Stomas/economics ; Time Factors ; Wound Closure Techniques/adverse effects ; Wound Closure Techniques/economics ; Wound Closure Techniques/psychology
    Language English
    Publishing date 2018-02-14
    Publishing country India
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 2299174-8
    ISSN 1998-4049 ; 1319-3767
    ISSN (online) 1998-4049
    ISSN 1319-3767
    DOI 10.4103/sjg.SJG_445_17
    Database MEDical Literature Analysis and Retrieval System OnLINE

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