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Biomedical subjects

Sandeep Aggarwal

Publications and source records attributed to Sandeep Aggarwal.

14 recordsLinked to original sources
PubMed2006

Transperitoneal, transmesocolic approach for laparoscopic excision of an extra-adrenal pheochromocytoma.

Laparoscopic surgery is an established treatment modality for adrenal disease, especially pheochromocytomas. We describe the successful excision of an extra-adrenal pheochromocytoma using a novel transperitoneal, transmesocolic approach. The tumor was located inferior to the left renal hilum in the para-aortic region and was found bulging through the descending mesocolon at laparoscopy. The tumor was removed without mobilization of the descending colon.

Humans↗
PubMed2005

Beta-sarcoglycanopathy.

Sarcoglycanopathies are relatively rare progressive muscular dystrophies with autosomal recessive inheritance; which belong to the group of limb girdle muscular dystrophies. The phenotype resembles dystrophinopathies due to proximal muscle weakness and calf hypertrophy. Reports from the Indian subcontinent are scarce. The authors report a case of primary beta-sarcoglycanopathy and describe literature pertaining to this rare entity.

Child, Preschool↗
PubMed2004

The role of 99mTc mebrofenin hepatobiliary scanning in predicting common bile duct stones in patients with gallstone disease.

BACKGROUND: A dilated common bile duct and/or elevated serum alkaline phosphatase, raises a suspicion of bile duct stone(s) in patients with gallstones. Cholangiography, either endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), is the best method for diagnosing bile duct stones. ERCP has the disadvantage of being invasive, and there is a risk of complications; while MRCP is costly and is not widely available. AIM: The objective of the present study was to evaluate the role of hepatobiliary nuclear scanning in diagnosing bile duct stones. METHODS: Twenty-five patients with suspected common bile duct (CBD) stones underwent hepatobiliary scintigraphy. The results of scintigraphy were compared with cholangiograms obtained by ERCP in 11 patients and MRCP in 14 patients, considering MRCP/ERCP as the 'gold standard'. RESULTS: Scintigraphy showed features suggestive of CBD stones in 11 of the 25 patients. The results of ERCP/MRCP confirmed that eight of them had stones. Scintigraphy showed no features of CBD stones in the remaining 14 patients. ERCP/MRCP showed CBD stones in two of these 14 patients. Thus, scintigraphy had a sensitivity of 80% and a specificity of 80%. CONCLUSION: We conclude that scintigraphy has good sensitivity and specificity in predicting CBD stones in patients with gallstone disease and a dilated CBD.

Adult↗
PubMed2004

Xanthogranulomatous pancreatitis: mass lesion of the pancreas simulating pancreatic carcinoma--a report of two cases.

Xathogranulomatous inflammation is well known in the gall bladder and kidney. Xanthogranulomatous pancreatitis has not been previously described. We report two cases of this new clinicopathologic entity. The first was a 50 years old male with cholelithiasis and progressive obstructive jaundice for 5 months. Radiology was suggestive of carcinoma head of pancreas and a Whipples procedure was performed. The second was a 36 years old male with choledocholithiasis and features of chronic pancreatitis. During pancreaticojejunostomy, a mass was found in the tail of pancreas, which was excised with a suspicion of carcinoma. Gross examination of both specimens showed firm grey white masses, demarcated from the surrounding pancreas but with infiltrative margins, and were thought to be carcinoma. Histopathological examination showed localized inflammation with numerous foamy histiocytes along with dilated ducts and microabscesses. A diagnosis of xanthogranulomatous pancreatitis was made in both instances. In view of clinical, radiological, operative and gross appearances of our cases simulating carcinoma, recognition of xanthogranulomatous chronic pancreatitis as a distinct clinicopathological entity seems important, analogous to similar lesions of the kidney and gall bladder.

Adult↗
PubMed2003

Primary cutaneous mucormycosis in an immunocompetent host: report of a case.

Cutaneous mucormycosis is an uncommon disease and it usually affects immunocompromised, diabetic, and trauma patients with contaminated wounds or patients with underlying malignancies. It is very rare to find this disease in immunocompetent, nondiabetic patients. We herein report a case of primary cutaneous mucormycosis in an immunocompetent and nondiabetic patient. Our patient was a 50-year-old veterinary doctor. He was diagnosed to have cutaneous mucormycosis of the anterior abdominal wall, and was treated with multiple debridements of the wound and intravenous amphotericin B therapy. He received a total of 1000 mg of amphotericin B. A high index of clinical suspicion and early institution of therapy in the form of surgical debridements and antifungal drugs are required to achieve a successful outcome.

Amphotericin B↗
PubMed2003

Fetal hydrocolpos leading to Pierre Robin sequence: an unreported effect of oligohydramnios sequence.

The presence of distal atretic vagina causing accumulation of fluid and mucus secretions in the proximal vaginal cavity resulted in fetal hydrocolpos. Obstructive uropathy developed gradually because of direct compression of hydrocolpos on bilateral lower ureters, resulting in oligohydramnios from decreased urine formation. Oligohydramnios inhibited normal mandibular development with resulting cleft palate and glossoptosis (Pierre Robin Sequence). The development of sequence of events in this case indicates Pierre Robin Sequence as another effect of Oligohydramnios Sequence arising out of deformational forces acting on cranio-facial structures.

Adult↗
PubMed2003

Spoke-wheel pattern in renal oncocytoma seen on double-phase helical CT.

Renal oncocytomas are benign, solid tumours of the kidney. An angiographic spoke-wheel pattern is known to be associated with oncocytomas, although it is not pathognomonic. On review of the literature, we found two reports of sonographic spoke-wheel appearance in oncocytomas. These were sufficiently characteristic to enable a confident preoperative diagnosis of oncocytoma. We present a case of a surgically proven oncocytoma with a distinct helical CT appearance, -commensurate with the angiographic and sonographic spoke-wheel appearance from which the diagnosis was suspected preoperatively.

Adenoma, Oxyphilic↗
PubMed2003

Portal vein thrombosis complicating neonatal hepatic abscess.

Hepatic abscess in a neonate is a rare but serious disorder. Diagnosis of hepatic abscess requires a high index of suspicion in any septic neonate. CT scan and ultrasound of liver are the most sensitive diagnostic tests in detection of hepatic abscess. Portal vein thrombosis and portal cavernoma formation is hitherto unreported complication of neonatal hepatic abscess in English literature. Present case report highlights the difficulty in diagnosis of neonatal hepatic abscess and describes the development of portal vein thrombosis and cavernoma during its treatment.

Female↗
PubMed2002

Subcutaneous myxopapillary ependymoma presenting as a childhood sacrococcygeal tumor: a case report.

Subcutaneous myxopapillary ependymoma in a sacrococcygeal location is an uncommon lesion. We report such a case in a 16-mo-old female child, who presented with a sacrococcygeal mass since birth. The cytological picture was that of a malignant small round cell tumor and the diagnosis was missed on cytology, which was retrospectively confirmed on comparison with histology. Although rare, this lesion can be a potential diagnostic pitfall and needs to be distinguished from other malignant tumors occurring at this age and at a similar location, like sacrococcygeal teratoma with immature elements, primitive neuroectodermal tumor (PNET), and PNET with ependymal differentiation.

Biomarkers, Tumor↗
PubMed2002

Thoracoscopy: the preferred approach for the resection of selected posterior mediastinal tumors.

The posterior mediastinum is a common site for neurogenic tumors. These are mostly asymptomatic and detected incidentally during radiologic investigations. However, they occasionally present with compressive or neurologic symptoms. The tumors are mostly benign but can also be malignant. Left untreated, they continue to grow. Therefore, once detected, resection is always advised. Traditionally, resection has been performed by standard posterolateral thoracotomy. More recently, such tumors have been removed thoracoscopically. We report our experience with three such cases and present a comprehensive analysis of cases of thoracoscopic resection of posterior mediastinal neurogenic tumors reported in the English literature to suggest guidelines for their current management.

Adult↗
PubMed2002

Thoracoscopy: the preferred method for excision of mediastinal parathyroids.

Mediastinal exploration to resect ectopic parathyroid is required in approximately 2% of all cases of hyperparathyroidism. Traditionally, it has been performed through a midsternotomy or thoracotomy. A few reports about thoracoscopic resection of mediastinal parathyroid were published recently. We report here successful video-assisted thoracoscopic resection (VATS) of a mediastinal parathyroid and present a review of all previously reported cases. A 42-year-old woman presented with spontaneous fracture of the left femur and hypercalcemia. She had previously undergone cervical parathyroidectomy for primary hyperparathyroidism. A computed tomography (CT) scan of the chest and a technetium scan showed ectopic mediastinal parathyroid. The patient underwent successful thoracoscopic resection of ectopic parathyroid. A total of 26 patients were reviewed, 21 in the English literature and 5 in others. Of the 21 patients reported in the English literature, 16 had primary hyperparathyroidism (1 degrees HPT), whereas 5 had secondary hyperparathyroidism (2 degrees HPT). All but 3 patients had undergone previous cervical exploration. Ectopic mediastinal parathyroid was localized preoperatively in all by CT scans of the chest and nuclear scans. All 21 patients had successful thoracoscopic resection. All but 3 had parathyroid adenoma. Postoperatively, serum calcium (Ca ), phosphate (PO4 ), and parathormone (PTH) values returned to normal in all patients. Age and sex of the patient, type of hyperparathyroidism (1 degrees or 2 degrees ), size of the gland, its location within the anterior mediastinum, the approach used to resect it (right or left thoracoscopic), and final histopathology of the resected gland (adenoma or hyperplasia) had no bearing on the success of thoracoscopic resection. The data seem to suggest that thoracoscopic resection of mediastinal parathyroid is a less-invasive, effective, and safe procedure. Accurate preoperative anatomic localization by CT and nuclear scans of the chest is the key to success.

Adult↗
PubMedDate not supplied

Infant gastroesophageal reflux disease score: reproducibility and validity in a developing country.

A 25-point infant gastro-oesophageal reflux disease (GERD) score based on 11 signs and symptoms of gastrooesophageal reflux (GER), to diagnose GERD has been suggested in infant. We carried out this study to test the reproducibility and validity of this scoring system in the cross-cultural settings of Indian infants. Caretakers of 610 apparently healthy infants, between the ages of 1 month and 24 months were administered the Orenstein's infant GER questionnaire and assigned a GERD score. Of these, 95 infants were taken up for a 24-hours oesophageal pH monitoring study. Before the pH study, each subject was again tested by the infant GER questionnaire by another independent observer and assigned an infant GERD score. The 24-hours oesophageal pH study was done using the Synectics Digitrapper MK III portable pH recording device. Reflux index (RI) >10% in infants up to 1 year of age and >5% in children more than 1 year of age was taken as pathological. Upper gastrointestinal endoscopy and oesophageal biopsies were performed in 35 cases, after taking informed consent. A good correlation was seen between the scores evaluated independently by the two workers, with a Pearson correlation coefficient of 0.906. The mean GERD score in infants with GER (as diagnosed by pH-metry) was 4.64 +/- 3.99 compared to 3.54 +/- 3.96 in those with no documented GER (p>0.05). A GERD score of 5 had a sensitivity of 43% and specificity of 79%, compared to 86% and 85% observed by Orenstein et al. in their series. The infant GER Questionnaire is easily adaptable and reproducible in the settings of developing countries. However, its diagnostic validity appears to be much less than that obtained by Orenstein et al. in their study on American infants.

Developing Countries↗