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Pediatric surgery is the surgical branch that uses operative techniques to correct certain pediatric conditions (i.e., congenital abnormalities, tumors, chronic diseases, and traumatic injuries). There are different specialties within the field that include: pediatric general surgery, pediatric otolaryngology (ear, nose, and throat), pediatric ophthalmology (eye), pediatric urology (urogenital system), pediatric orthopedic (bone) surgery, pediatric neurological (brain and spinal cord) surgery, pediatric plastic (reconstructive and cosmetic) surgery
Faculty
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Achievments & Recognitions
Best Pediatric Surgeon
Publications
2023
1.
Fatima, Asma; Prasad, G. Raghavendra; Ali, Shaik Zahid; Bokhari, Syed Faqeer Hussain; Abedi, Syed Abul Qasim Hussain; Júnior, Ricardo Souza
Rare presentation of vagal paraganglioma in an early age: a case report and literature review Journal Article
In: International Journal of Surgery Case Reports, vol. 107, pp. 108362, 2023, ISSN: 2210-2612.
@article{Fatima_2023b,
title = {Rare presentation of vagal paraganglioma in an early age: a case report and literature review},
author = {Asma Fatima and G. Raghavendra Prasad and Shaik Zahid Ali and Syed Faqeer Hussain Bokhari and Syed Abul Qasim Hussain Abedi and Ricardo Souza Júnior},
url = {https://pdf.sciencedirectassets.com/280165/1-s2.0-S2210261223X00066/1-s2.0-S2210261223004911/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEC8aCXVzLWVhc3QtMSJHMEUCIQDBGpUAAJD3f4cMWDSpTP9KNAmfiqJuoA2VkMv1kpifewIgaoAtoaMe7gNW2h2TLLww7V723OfVF44AfhsXxfcRqkkqsgUIKBAFGgwwNTkwMDM1NDY4NjUiDObQAAbK97IuiuD3miqPBYbr69qJ5oidw3icepSWPNNF4yqMwaOeUk6pf2JnKuCVM%2B2AqyaL1w63PMLM93qX7pK1lV%2BA8GPVlnP6vlSoXwkCDN4Nvpr2tqZbMn6BMAVLjYgROzQSheLwupsztBH1qeYvixkfMw%2BTSxE8o33pVxAHz6UTeT4RoO%2BBnSgDzO6jpdvemOm9HAn9Rmg2TtDvH3%2FqPvt6UkYy7z1VBCluhaoqeBjLoczsZ9f9Xr%2FrckqH5p1mL7pLaG%2FNNbIY16u9dAiBCXnv3jdZXwSyELCTdQlmcf%2BuzDija9wmpFvQ8Kd7iWPJ2PDV%2FelnKEfrbRKOkQI6jLZmPG5JjpYd%2FmvfMiU5LDGwAfvpIoUgbykG2V2cIEMXS%2FD1Dh0KmC2qEzrt6U8mEN6iwEsYlq%2B2qumXbRrzrenm4z0BOvZ4CVo%2FPpf8x3UNZ%2BESOJSlC6XlHwmv236oCY1oDW0DVMecwOYQ3QMgGW9sXZo6bBRoutMBF92kmzlFnvIW9RA%2FvzWx%2FrwQdYAJ8kA0jkjtVRkfF66cYv55vgZTcWFdrMOzHbjVjOgUbmcEyccgMQjGxSrTZi8hxqYbeTwvlNgnEneA86Os7l7S02s%2FiWWAtnNCk6Iwf37078%2Bs4tVTl1p7CCDYfsNARgJGszsnaMCJjUc9Xjt5puBA5qvRhY8HIwUlaEiQ2giSG9Pu3gzLxv9JYqAo9HdtU5Z8yw4Eq5gezpfAJ5i47fpI0zpsX1Fhm8xPpAeDdLpzNQJFa%2FtqBYmNxGMhizrCjKAoLfkP6w0JLzOfgGf8bNEihnioVgtxZdE3vVjXtHpamngRAvhnR%2F1l5vTyulq2sr0%2B4bc1zEdfwa5gVwyQMTXEcYb3hnPBaguTpmydgxgwwJm6qAY6sQEZFVpUp4ow8UY9TWysO9tIPa2h7AgOp%2BGRJMK%2BQ83L8lEHhpGGyeap8ydxQTxgjSG1%2BeN9VDRf8HAtR0OzV%2BR2MwTLz5V2Wn3xaM4i4dUxCrerMOC9P2fuGcO5exrX5Wujsv%2B8%2Bk0%2BKeJKJhIkl9%2Bus9OIwz4XAMilWgHDdY%2Ba2yA2p4qRv0h%2FHAxmMIm57vDRXDBpe30aRTccT8Fd%2B0%2BJmbpsK%2F1umKB7hDiUH4lr0DU%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20230923T073437Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYQNTLULHS%2F20230923%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=5cf2ce751a3f530d41d876d5adc18b4524aedeb75bf0ccb2c500677a57832012&hash=4f124584f3bb971c35e6edd96d2a338341f63587e5dd785f792c5ea486738432&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S2210261223004911&tid=spdf-97b6fb85-7d4b-4620-a09e-da76325953a4&sid=d3a802bb9c9bc24c5d8ab168346de759acb2gxrqb&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=0f0d5750015654015753&rr=80b11b32889d2e87&cc=in},
doi = {10.1016/j.ijscr.2023.108362},
issn = {2210-2612},
year = {2023},
date = {2023-05-27},
urldate = {2023-05-27},
journal = {International Journal of Surgery Case Reports},
volume = {107},
pages = {108362},
publisher = {Elsevier BV},
abstract = {Introduction and importance: Vagal paragangliomas of neck are rare tumours of neural crest origin usually arising in elderly age with female predominance. They have a vague clinical presentation therefore difficult to diagnose preoperatively. We hope that this case report and literature review would add to the existing literature and help devise a comprehensive diagnostic and therapeutic plan for vagal paragangliomas. Case presentation: We report a case of vagal paraganglioma occurring in a 13-year-old male which is an extremely rare presentation in this age group. The patient presented with a large solitary painless progressively growing mass in posterior triangle of neck. External jugular vein was stretched and trachea was deviated medially. The mass was arising via a twig from vagus nerve and was surgically excised. Diagnosis was established post-operatively through histopathological analysis. Clinical discussion: Vagal paraganglioma is a rare occurrence in male teenagers and may mimic schwannoma, neuroma, jugular meningioma, or other gangliomas. Surgical excision is mainstay of treatment but resultant vagal complications and neurological consequences are usually unavoidable. Nonetheless, the prognosis may be easily improved with sound surgical judgement, skill, and routine follow-up. Conclusions: Vagal paraganglioma usually presents as a swelling in neck and cannot be diagnosed on simple clinical examination. CT scan and MRI are imaging modalities of choice and can be coupled with angiography to increase diagnostic accuracy. Although both radiation therapy and surgical excision have both been found to be successful treatment options, it is still unclear which is more beneficial.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction and importance: Vagal paragangliomas of neck are rare tumours of neural crest origin usually arising in elderly age with female predominance. They have a vague clinical presentation therefore difficult to diagnose preoperatively. We hope that this case report and literature review would add to the existing literature and help devise a comprehensive diagnostic and therapeutic plan for vagal paragangliomas. Case presentation: We report a case of vagal paraganglioma occurring in a 13-year-old male which is an extremely rare presentation in this age group. The patient presented with a large solitary painless progressively growing mass in posterior triangle of neck. External jugular vein was stretched and trachea was deviated medially. The mass was arising via a twig from vagus nerve and was surgically excised. Diagnosis was established post-operatively through histopathological analysis. Clinical discussion: Vagal paraganglioma is a rare occurrence in male teenagers and may mimic schwannoma, neuroma, jugular meningioma, or other gangliomas. Surgical excision is mainstay of treatment but resultant vagal complications and neurological consequences are usually unavoidable. Nonetheless, the prognosis may be easily improved with sound surgical judgement, skill, and routine follow-up. Conclusions: Vagal paraganglioma usually presents as a swelling in neck and cannot be diagnosed on simple clinical examination. CT scan and MRI are imaging modalities of choice and can be coupled with angiography to increase diagnostic accuracy. Although both radiation therapy and surgical excision have both been found to be successful treatment options, it is still unclear which is more beneficial.
2022
2.
Harooni, Syed Asif Shah; Prasad, G. Raghavendra; Danda, Gayatri Reddy; Naureen, Mahera
Mortality prediction score for hirschsprung's disease-associated enterocolitis: a novel mortality prediction model Journal Article
In: Journal of Indian Association of Pediatric Surgeons, vol. 27, iss. 5, no. pmid36530801, pp. 594-599, 2022, ISSN: 0971-9261.
@article{Harooni_2022,
title = {Mortality prediction score for hirschsprung's disease-associated enterocolitis: a novel mortality prediction model},
author = {Syed Asif Shah Harooni and G. Raghavendra Prasad and Gayatri Reddy Danda and Mahera Naureen},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757779/?report=reader},
doi = {10.4103/jiaps.jiaps_243_21},
issn = {0971-9261},
year = {2022},
date = {2022-09-09},
urldate = {2022-09-09},
journal = {Journal of Indian Association of Pediatric Surgeons},
volume = {27},
number = {pmid36530801},
issue = {5},
pages = {594-599},
abstract = {Introduction: Enterocolitis associated with Hirschsprung's disease is a fatal and serious complication. Number of scoring systems are in vogue to grade the severity of Hirschsprung's disease associated with enterocolitis (HDAEC), but none of these scoring systems help predict mortality. Hence, we attempt to develop a mortality prediction model (MPM) for HDAEC. Materials and Methods: A retrospective analysis of all cases of HDAEC encountered was analyzed. We also used the parameters of Elhalaby et al. for data collection. A total number of 71 cases were analyzed with regard to mortality in relation to each parameter. Sensitivity and specificity were calculated by statistician, and based on these values, a scoring model was proposed. All those with predicted mortality were given score 2 and those who did not were given score 1. Results: A total score of more than 16 predicted mortality, a score of <10 predicted survival, and a score between 11 and 15 predicted survival with morbidity. Conclusion: A MPM for HDAEC is being proposed.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Enterocolitis associated with Hirschsprung's disease is a fatal and serious complication. Number of scoring systems are in vogue to grade the severity of Hirschsprung's disease associated with enterocolitis (HDAEC), but none of these scoring systems help predict mortality. Hence, we attempt to develop a mortality prediction model (MPM) for HDAEC. Materials and Methods: A retrospective analysis of all cases of HDAEC encountered was analyzed. We also used the parameters of Elhalaby et al. for data collection. A total number of 71 cases were analyzed with regard to mortality in relation to each parameter. Sensitivity and specificity were calculated by statistician, and based on these values, a scoring model was proposed. All those with predicted mortality were given score 2 and those who did not were given score 1. Results: A total score of more than 16 predicted mortality, a score of <10 predicted survival, and a score between 11 and 15 predicted survival with morbidity. Conclusion: A MPM for HDAEC is being proposed.
2019
3.
Sharma, Shilpa; Joshi, Manoj; Gupta, Devendra K.; Abraham, Mohan; Mathur, Praveen; Mahajan, J. K.; Gangopadhyay, A. N.; Rattan, Simmi K.; Vora, Ravindra; Prasad, G. Raghavendra; Bhattacharya, N. C.; Samuj, Ram; Rao, K. L. N.; Basu, A. K.
Consensus on the management of posterior urethral valves from antenatal period to puberty Journal Article
In: Journal of Indian Association of Pediatric Surgeons, vol. 24, iss. 1, pp. 4-14, 2019, ISSN: 0971-9261.
@article{Sharma_2019,
title = {Consensus on the management of posterior urethral valves from antenatal period to puberty},
author = {Shilpa Sharma and Manoj Joshi and Devendra K. Gupta and Mohan Abraham and Praveen Mathur and J. K. Mahajan and A. N. Gangopadhyay and Simmi K. Rattan and Ravindra Vora and G. Raghavendra Prasad and N. C. Bhattacharya and Ram Samuj and K. L. N. Rao and A. K. Basu},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322183/?report=reader},
doi = {10.4103/jiaps.JIAPS_148_18},
issn = {0971-9261},
year = {2019},
date = {2019-03-31},
urldate = {2019-03-31},
journal = {Journal of Indian Association of Pediatric Surgeons},
volume = {24},
issue = {1},
pages = {4-14},
abstract = {The need for successful management of posterior urethral valves always captivates the minds of pediatric surgeons. Its success, however, depends on several factors ranging from prenatal preservation of upper tracts to postoperative pharmacological compliance. Regardless of measures available, some cases do not respond and progress to end stage. The management depends on several issues ranging from age and severity at presentation to long-term follow-up and prevention of secondary renal damage and managing valve bladder syndrome. This article is based on a consensus to the set of questionnaires, prepared by research section of Indian Association of Paediatric Surgeons and discussed by experienced pediatric surgeons based in different institutions in the country. Standard operating procedures for conducting a voiding cystourethrogram and cystoscopy were formulated. Age-wise contrast dosage was calculated for ready reference. Current evidence from literature was also reviewed and included to complete the topic.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The need for successful management of posterior urethral valves always captivates the minds of pediatric surgeons. Its success, however, depends on several factors ranging from prenatal preservation of upper tracts to postoperative pharmacological compliance. Regardless of measures available, some cases do not respond and progress to end stage. The management depends on several issues ranging from age and severity at presentation to long-term follow-up and prevention of secondary renal damage and managing valve bladder syndrome. This article is based on a consensus to the set of questionnaires, prepared by research section of Indian Association of Paediatric Surgeons and discussed by experienced pediatric surgeons based in different institutions in the country. Standard operating procedures for conducting a voiding cystourethrogram and cystoscopy were formulated. Age-wise contrast dosage was calculated for ready reference. Current evidence from literature was also reviewed and included to complete the topic.
2018
4.
Prasad, G. Raghavendra; Lakshmi, C. V. S.
Down‘s syndrome‑ an independent risk factor of outcomes in isolated congenital duodenal atresia Journal Article
In: Journal of Neonatal Surgery , vol. 7, iss. 3, pp. 32-35, 2018, ISSN: 2226-0439.
@article{Prasad_2018,
title = {Down‘s syndrome‑ an independent risk factor of outcomes in isolated congenital duodenal atresia},
author = {G. Raghavendra Prasad and C. V. S. Lakshmi},
url = {https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/440/pdf},
doi = {10.21699/jns.v7i3.787},
issn = {2226-0439},
year = {2018},
date = {2018-07-24},
urldate = {2018-07-24},
journal = {Journal of Neonatal Surgery },
volume = {7},
issue = {3},
pages = {32-35},
abstract = {Introduction: There is no consensus in the available literature whether the coexistence of Down’s syndrome has adverse effect on the outcomes of neonates born with congenital duodenal atresia. Materials and Methods: A total of 29 neonates with congenital duodenal atresia were retrospectively studied for demographic details, sepsis parameters at admission, management, morbidity, and mortality. The neonates who were premature. Results: The sepsis parameters such as total leukocyte counts, erythrocyte sedimentation rate, serum procalcitonin levels, and serum C‑reactive protein levels were significantly increased, and the platelets were significantly decreased at admission in Group B subjects, as compared to Group A subjects. There were no complications noted in Group A, while Group B had significant morbidity. The neonates with congenital duodenal atresia with Down’s syndrome had 3.27 times more relative risk of mortality than those without Down’s syndrome. Down’s syndrome appears to be an independent risk factor for mortality in isolated congenital duodenal atresia with attributable risk of 37.8%. Conclusion: The presence of Down’s syndrome is a significant independent adverse risk factor of outcomes in isolated congenital duodenal atresia.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: There is no consensus in the available literature whether the coexistence of Down’s syndrome has adverse effect on the outcomes of neonates born with congenital duodenal atresia. Materials and Methods: A total of 29 neonates with congenital duodenal atresia were retrospectively studied for demographic details, sepsis parameters at admission, management, morbidity, and mortality. The neonates who were premature. Results: The sepsis parameters such as total leukocyte counts, erythrocyte sedimentation rate, serum procalcitonin levels, and serum C‑reactive protein levels were significantly increased, and the platelets were significantly decreased at admission in Group B subjects, as compared to Group A subjects. There were no complications noted in Group A, while Group B had significant morbidity. The neonates with congenital duodenal atresia with Down’s syndrome had 3.27 times more relative risk of mortality than those without Down’s syndrome. Down’s syndrome appears to be an independent risk factor for mortality in isolated congenital duodenal atresia with attributable risk of 37.8%. Conclusion: The presence of Down’s syndrome is a significant independent adverse risk factor of outcomes in isolated congenital duodenal atresia.
5.
Prasad, G. Raghavendra; Rao, J. V. Subba; Aziz, Amtul; Rashmi, T. M.; Ahmed, Saniya
Early enteral nutrition in neonates following abdominal surgery Journal Article
In: Journal of Neonatal Surgery, vol. 7, iss. 2, pp. 21, 2018, ISSN: 2226-0439.
@article{Prasad_2018b,
title = {Early enteral nutrition in neonates following abdominal surgery},
author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi and Saniya Ahmed},
url = {https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/384/pdf},
doi = {10.21699/jns.v7i2.740},
issn = {2226-0439},
year = {2018},
date = {2018-04-08},
urldate = {2018-04-08},
journal = {Journal of Neonatal Surgery},
volume = {7},
issue = {2},
pages = {21},
abstract = {Introduction: Nil per oral (NPO)/nil by mouth has been the most commonly practiced convention in post-operative period. Misplaced fear of aspiration led to routine prescription of “NPO.” Starvation leads to atrophy of the gut mucosa leading to decreased barrier effect of gut mucosa. This starvation-induced gut mucosal injury increases septic complications and mortality. The study aims at establishing the feasibility and effect of early enteral nutrition (EEN) in neonates following abdominal surgeries. Materials and Methods: A total of 260 cases formed the cohort of prospective cohort study, 79 in EEN - Group “A” and 181 in NPO - Group “B.” Effect of EEN was evaluated with regard to outcome, hospital stay, surgical site infections (SSI), stress markers such as C-reactive protein (CRP), procalcitonin, tumor necrosis factor alpha (TNF α), and neonatal-predisposition, insult/injury, response, organ failure (Neo-PIRO) scores, intra-abdominal pressure (IAP) grade, tolerance of feeds, and time to first stool. Chi-square was the statistical method used. Epi info version 7 was the software used. Results: Group B had higher mortality (20.09%) than Group A (P < 0.05). 33.7 in Group B developed SSI, of which 90% were deep and intracavitary (P < 0.05). Hospital stay was less in Group A (P < 0.05). CRP and Neo-PIRO scores were less in Group A compared to Group B (P < 0.05). TNF-α expression and IAP scores were not statistically significant (P > 0.05). Procalcitonin levels were higher in Group B. Feeds were better tolerated in Group A. First stool appeared earlier in Group A than B. There was no difference in anastomotic leak in both the groups. Conclusion: EEN in neonates following abdominal surgeries is feasible, well tolerated reduces the hospital stay and mortality, and reduces SSIs, and early gut motility could be established.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Nil per oral (NPO)/nil by mouth has been the most commonly practiced convention in post-operative period. Misplaced fear of aspiration led to routine prescription of “NPO.” Starvation leads to atrophy of the gut mucosa leading to decreased barrier effect of gut mucosa. This starvation-induced gut mucosal injury increases septic complications and mortality. The study aims at establishing the feasibility and effect of early enteral nutrition (EEN) in neonates following abdominal surgeries. Materials and Methods: A total of 260 cases formed the cohort of prospective cohort study, 79 in EEN - Group “A” and 181 in NPO - Group “B.” Effect of EEN was evaluated with regard to outcome, hospital stay, surgical site infections (SSI), stress markers such as C-reactive protein (CRP), procalcitonin, tumor necrosis factor alpha (TNF α), and neonatal-predisposition, insult/injury, response, organ failure (Neo-PIRO) scores, intra-abdominal pressure (IAP) grade, tolerance of feeds, and time to first stool. Chi-square was the statistical method used. Epi info version 7 was the software used. Results: Group B had higher mortality (20.09%) than Group A (P < 0.05). 33.7 in Group B developed SSI, of which 90% were deep and intracavitary (P < 0.05). Hospital stay was less in Group A (P < 0.05). CRP and Neo-PIRO scores were less in Group A compared to Group B (P < 0.05). TNF-α expression and IAP scores were not statistically significant (P > 0.05). Procalcitonin levels were higher in Group B. Feeds were better tolerated in Group A. First stool appeared earlier in Group A than B. There was no difference in anastomotic leak in both the groups. Conclusion: EEN in neonates following abdominal surgeries is feasible, well tolerated reduces the hospital stay and mortality, and reduces SSIs, and early gut motility could be established.
2017
6.
Prasad, G. Raghavendra; Rao, J. V. Subba; Aziz, Amtul; Rashmi, T. M.
"Neo-PIRO": introducing a novel grading system for surgical infections of neonates Journal Article
In: Journal of Indian Association of Pediatric Surgeons, vol. 22, iss. 4, pp. 211-216, 2017, ISSN: 0971-9261.
@article{Prasad_2017b,
title = {"Neo-PIRO": introducing a novel grading system for surgical infections of neonates},
author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615894/?report=reader},
doi = {10.4103/0971-9261.214455},
issn = {0971-9261},
year = {2017},
date = {2017-12-31},
urldate = {2017-12-31},
journal = {Journal of Indian Association of Pediatric Surgeons},
volume = {22},
issue = {4},
pages = {211-216},
abstract = {Introduction: Quantification of surgical sepsis was never done beyond superficial, subfascial, and deep surgical site infection (SSI). Invasive surgical sepsis with systemic manifestation has not been tried to be quantified in general and pediatric surgery in particular. Hence, this attempts to develop a novel grading system to quantify neonatal surgical infections. Materials and Methods Predisposing factors, infection, response, and organ failure (PIRO) is being used in critical care institutions for medical sepsis; it was modified with neonate-specific surgical parameters. Authors have developed a grading of these parameters into Grade I, II, and III. Results: A blinded statistical test was performed and results were put to test. Extended Mantel–Haenszel Chi-square test validated linear relationship with grade and outcome, hospital stay, deep SSI, and organ dysfunction. Analysis of variance also showed the significant relationship of changing trends in grade and outcome. (1) Higher the grade indicated the probability of death. (2) Grade I patients had less duration of hospital stay compared to Grade II and III (P = 0.04). (3) The requirement of organ support and SSI were also more in Grade III. (4) Grade I patients had less increase in trends compared to Grade II and III (F = 4.86). Authors therefore feel Neo-PIRO seems to be the first scoring system that shows a linear relationship between scores and grade. Conclusion: Neo-PIRO is a novel grading system with surgical neonate-specific parameters. Future versions to include molecular parameters, as well as parameters selected by regression analysis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Quantification of surgical sepsis was never done beyond superficial, subfascial, and deep surgical site infection (SSI). Invasive surgical sepsis with systemic manifestation has not been tried to be quantified in general and pediatric surgery in particular. Hence, this attempts to develop a novel grading system to quantify neonatal surgical infections. Materials and Methods Predisposing factors, infection, response, and organ failure (PIRO) is being used in critical care institutions for medical sepsis; it was modified with neonate-specific surgical parameters. Authors have developed a grading of these parameters into Grade I, II, and III. Results: A blinded statistical test was performed and results were put to test. Extended Mantel–Haenszel Chi-square test validated linear relationship with grade and outcome, hospital stay, deep SSI, and organ dysfunction. Analysis of variance also showed the significant relationship of changing trends in grade and outcome. (1) Higher the grade indicated the probability of death. (2) Grade I patients had less duration of hospital stay compared to Grade II and III (P = 0.04). (3) The requirement of organ support and SSI were also more in Grade III. (4) Grade I patients had less increase in trends compared to Grade II and III (F = 4.86). Authors therefore feel Neo-PIRO seems to be the first scoring system that shows a linear relationship between scores and grade. Conclusion: Neo-PIRO is a novel grading system with surgical neonate-specific parameters. Future versions to include molecular parameters, as well as parameters selected by regression analysis.
7.
Prasad, G. Raghavendra; Rao, J. V. Subba; Aziz, Amtul; Rashmi, T. M.
The role of routine measurement of intra-abdominal pressure in preventing abdominal compartment syndrome Journal Article
In: Journal of Indian Association of Pediatric Surgeons, vol. 22, iss. 3, pp. 134-138, 2017, ISSN: 0971-9261.
@article{Prasad_2017,
title = {The role of routine measurement of intra-abdominal pressure in preventing abdominal compartment syndrome},
author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473297/?report=reader},
doi = {10.4103/jiaps.JIAPS_222_15},
issn = {0971-9261},
year = {2017},
date = {2017-09-30},
urldate = {2017-09-30},
journal = {Journal of Indian Association of Pediatric Surgeons},
volume = {22},
issue = {3},
pages = {134-138},
abstract = {Introduction: Abdomen, a closed compartment, is prone to raised intra-abdominal pressure (IAP) in the postoperative period. After a critical value of ≥ 15 cm of water, IAP produces abdominal compartment syndrome (ACS). ACS leads to reduced venous return, reduced cardiac output, and domino effect of organ dysfunction, leading to death. Hence, it is the need of hour to monitor IAP to pick up intra-abdominal hypertension (IAH) and ACS. This routine facilitates early institution of treatment measures. Aims and Objectives: To study IAP in abdominal operations in neonates, infants, and older children and to promote concept of routine measurement of IAP as standard care. Materials and Methods: Intravesical route was used to measure IAP in this prospective observational study. Seventy-nine pediatric abdominal surgeries met with criteria of availability of complete data for analysis and formed the cohort of the study. All major, infective, traumatic, tumor-related abdominal surgeries were included in the study. Outcome, C-reactive protein (CRP), procalcitonin, platelet counts, Simplified Sequential Organ Failure Assessment Score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were the parameters analyzed. The World Society of ACS grading was adopted in the study with subdivision of normal into low-normal and high-normal subgroups. Results:
Extended Mantel–Haenszel Chi-square statistical tool when applied for linear relationship showed a linear relationship with outcome (P < 0.05), CRP (P < 0.05), procalcitonin (P < 0.05), Simplified Sequential organ failure Assessment Score, and APACHE II. Platelet counts (P > 0.05) were not significantly correlated. Decision for laparotomy was delayed in cases of ACS. Conclusion: Routine measure of IAP facilitates early recognition of IAH. This facilitates therapeutic measures to be initiated to reduce IAP. Early decision to decompress by laparotomy/laparostomy saves lives. Hence, routine IAP measurement should be a part of standard care in pediatric abdominal surgery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Abdomen, a closed compartment, is prone to raised intra-abdominal pressure (IAP) in the postoperative period. After a critical value of ≥ 15 cm of water, IAP produces abdominal compartment syndrome (ACS). ACS leads to reduced venous return, reduced cardiac output, and domino effect of organ dysfunction, leading to death. Hence, it is the need of hour to monitor IAP to pick up intra-abdominal hypertension (IAH) and ACS. This routine facilitates early institution of treatment measures. Aims and Objectives: To study IAP in abdominal operations in neonates, infants, and older children and to promote concept of routine measurement of IAP as standard care. Materials and Methods: Intravesical route was used to measure IAP in this prospective observational study. Seventy-nine pediatric abdominal surgeries met with criteria of availability of complete data for analysis and formed the cohort of the study. All major, infective, traumatic, tumor-related abdominal surgeries were included in the study. Outcome, C-reactive protein (CRP), procalcitonin, platelet counts, Simplified Sequential Organ Failure Assessment Score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were the parameters analyzed. The World Society of ACS grading was adopted in the study with subdivision of normal into low-normal and high-normal subgroups. Results:
Extended Mantel–Haenszel Chi-square statistical tool when applied for linear relationship showed a linear relationship with outcome (P < 0.05), CRP (P < 0.05), procalcitonin (P < 0.05), Simplified Sequential organ failure Assessment Score, and APACHE II. Platelet counts (P > 0.05) were not significantly correlated. Decision for laparotomy was delayed in cases of ACS. Conclusion: Routine measure of IAP facilitates early recognition of IAH. This facilitates therapeutic measures to be initiated to reduce IAP. Early decision to decompress by laparotomy/laparostomy saves lives. Hence, routine IAP measurement should be a part of standard care in pediatric abdominal surgery.
Extended Mantel–Haenszel Chi-square statistical tool when applied for linear relationship showed a linear relationship with outcome (P < 0.05), CRP (P < 0.05), procalcitonin (P < 0.05), Simplified Sequential organ failure Assessment Score, and APACHE II. Platelet counts (P > 0.05) were not significantly correlated. Decision for laparotomy was delayed in cases of ACS. Conclusion: Routine measure of IAP facilitates early recognition of IAH. This facilitates therapeutic measures to be initiated to reduce IAP. Early decision to decompress by laparotomy/laparostomy saves lives. Hence, routine IAP measurement should be a part of standard care in pediatric abdominal surgery.
8.
Marupaka, Sravan Kumar; Irfan, Kazi Amir; Prasad, G. Raghavendra; Venkateshwarlu, Jampala; Abkari, Anand; Naseeruddin, Mohammed
Intraarticular injuries in pediatric knee in relation to physeal closure- an MRI study Journal Article
In: Indian Journal of Applied Research, vol. 7, iss. 8, pp. 173-176, 2017, ISSN: 2249-555X.
@article{Marupaka_2017,
title = {Intraarticular injuries in pediatric knee in relation to physeal closure- an MRI study},
author = {Sravan Kumar Marupaka and Kazi Amir Irfan and G. Raghavendra Prasad and Jampala Venkateshwarlu and Anand Abkari and Mohammed Naseeruddin},
url = {https://www.worldwidejournals.com/indian-journal-of-applied-research-(IJAR)/fileview/August_2017_1501589395__63.pdf},
issn = {2249-555X},
year = {2017},
date = {2017-08-01},
urldate = {2017-08-01},
journal = {Indian Journal of Applied Research},
volume = {7},
issue = {8},
pages = {173-176},
abstract = {INTRODUCTION: It is found that ACL injury in younger age is a significant public health burden with gradually rising incidence over the last decade. Present study is about the incidence of ACL injuries and associated meniscal and osteochondral injuries in children aged less than 18years with comparison of the pattern of various injuries before and after closure of physes. MATERIAL AND METHODS: Children were divided into two groups depending on the status of closure of the physis. Intra articular injuries involving cruciate ligaments, menisci and articular cartilage were analyzed for prevalence in relation to the skeletal maturity. RESULTS:
Complete rupture including avulsion was significantly more common in mature skeleton and partial tears were more common in immature skeleton with a p value of 0.039 (less than 0.05). CONCLUSION: Commonest injuries involved ACL followed by medial meniscal tears, osteochodral lesions and lateral meniscal injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: It is found that ACL injury in younger age is a significant public health burden with gradually rising incidence over the last decade. Present study is about the incidence of ACL injuries and associated meniscal and osteochondral injuries in children aged less than 18years with comparison of the pattern of various injuries before and after closure of physes. MATERIAL AND METHODS: Children were divided into two groups depending on the status of closure of the physis. Intra articular injuries involving cruciate ligaments, menisci and articular cartilage were analyzed for prevalence in relation to the skeletal maturity. RESULTS:
Complete rupture including avulsion was significantly more common in mature skeleton and partial tears were more common in immature skeleton with a p value of 0.039 (less than 0.05). CONCLUSION: Commonest injuries involved ACL followed by medial meniscal tears, osteochodral lesions and lateral meniscal injuries.
Complete rupture including avulsion was significantly more common in mature skeleton and partial tears were more common in immature skeleton with a p value of 0.039 (less than 0.05). CONCLUSION: Commonest injuries involved ACL followed by medial meniscal tears, osteochodral lesions and lateral meniscal injuries.
9.
Prasad, G. Raghavendra; Aziz, Amtul
Abdominal plain radiograph in neonatal intestinal obstruction Journal Article
In: Journal of Neonatal Surgery, vol. 6, iss. 1, pp. 1-6, 2017, ISSN: 2226-0439.
@article{Prasad_2017,
title = {Abdominal plain radiograph in neonatal intestinal obstruction},
author = {G. Raghavendra Prasad and Amtul Aziz},
url = {https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/469/pdf3},
doi = {10.21699/jns.v6i1.483},
issn = {2226-0439},
year = {2017},
date = {2017-01-01},
urldate = {2016-12-01},
journal = {Journal of Neonatal Surgery},
volume = {6},
issue = {1},
pages = {1-6},
publisher = {Journal of Neonatal Surgery},
abstract = {A comprehensive all-inclusive resource on plain radiograph in neonatal intestinal obstruction is presented. This is an attempt to develop a protocol and to regain expertise in evaluating a plain radiograph that most often yields more than enough clues to diagnose and to decide a plan of action.},
key = {pmid28083492},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A comprehensive all-inclusive resource on plain radiograph in neonatal intestinal obstruction is presented. This is an attempt to develop a protocol and to regain expertise in evaluating a plain radiograph that most often yields more than enough clues to diagnose and to decide a plan of action.
2016
10.
Nori, Madhavi; Prasad, G. Raghavendra; Reddy, Arvind K.; Cheguri, Sandeep Reddy
Fetal MR imaging analysis of sirenomelia with clinico radiographic correlation: a case report Journal Article
In: Journal of Clinical and Diagnostic Research, vol. 10, iss. 6, pp. TD08-TD10, 2016, ISSN: 0973-709X.
@article{Nori_2016,
title = {Fetal MR imaging analysis of sirenomelia with clinico radiographic correlation: a case report},
author = {Madhavi Nori and G. Raghavendra Prasad and Arvind K. Reddy and Sandeep Reddy Cheguri},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963740/pdf/jcdr-10-TD08.pdf},
doi = { 10.7860/JCDR/2016/19117.8057},
issn = {0973-709X},
year = {2016},
date = {2016-06-01},
urldate = {2016-06-01},
journal = {Journal of Clinical and Diagnostic Research},
volume = {10},
issue = {6},
pages = {TD08-TD10},
abstract = {Sirenomelia is a social curiosity, a medical and diagnostic challenge prenatally compounded by varied diagnostic difficulties. Prenatal diagnosis of sirenomelia was and continues to be a challenge although von klippel et al., described a case at 10 weeks of gestational age. However, they needed a second imaging at 12(th) week for confirmation. First trimester or early second trimester anatomic survey on ultrasound and MRI is accurate for the diagnosis thereby avoiding unnecessary complex pregnancy. We report a case of second trimester diagnosed sirenomelia, with detailed analysis of image findings on ultrasound and fetal MRI. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sirenomelia is a social curiosity, a medical and diagnostic challenge prenatally compounded by varied diagnostic difficulties. Prenatal diagnosis of sirenomelia was and continues to be a challenge although von klippel et al., described a case at 10 weeks of gestational age. However, they needed a second imaging at 12(th) week for confirmation. First trimester or early second trimester anatomic survey on ultrasound and MRI is accurate for the diagnosis thereby avoiding unnecessary complex pregnancy. We report a case of second trimester diagnosed sirenomelia, with detailed analysis of image findings on ultrasound and fetal MRI.
2015
11.
Prasad, G. Raghavendra; Aishwarya, Kasha; Rao, J. V. Subba
A study of impact of early diagnosis in the management of choledochal cysts of infancy and childhood– experience and analysis of 205 cases Journal Article
In: Global Journal of Medical Research, vol. 15, iss. 2, pp. 9-15, 2015, ISSN: 0975-587X.
@article{Prasad_2015c,
title = {A study of impact of early diagnosis in the management of choledochal cysts of infancy and childhood– experience and analysis of 205 cases},
author = {G. Raghavendra Prasad and Kasha Aishwarya and J. V. Subba Rao},
url = {https://medicalresearchjournal.org/index.php/GJMR/article/view/100518/5702},
issn = {0975-587X},
year = {2015},
date = {2015-07-14},
urldate = {2015-07-14},
journal = {Global Journal of Medical Research},
volume = {15},
issue = {2},
pages = {9-15},
abstract = {Introduction: Choledochal cyst not an uncommon encountered pediatric surgical practices. Advances in technology have impacted timing of diagnosis. Advances in instrumentation and surgical access have added yet another way of excion. But the exact impact of early diagnosis on surgery of choledochal cysts have not been analysed and reported. Hence this attempt to analyse the three periods of choledochal cyst, namely 1. PTC (Percutaneous Trans-hepatic Cholangiography) and ERCP (Endoscopic Retrograde Cholangio Pancreatography), 2. USG (Ultrasonography) and CT Scan (Computerised Tomography era, and 3 .Period of MRCP (Magnetic Resonnace Cholangio Pancreaticography) with regards to impact of early diagnosis in the management of Choledochal cysts. Materials and Methods: A total of 205 cases of choledochal cysts treated by the team were analyzed. The data retrieval was from a self developed Microsoft Access based software used by senior pediatric surgeon. The parameter studied was actual impact on surgical aspects of the three main components of surgery of choledochal cysts, namely 1. Approach to cyst excision per se, 2. Management of distal end, 3. Restoration biliary drainage. Results: The advances in imageology have lead to early diagnosis and early surgery before complications develop. This has impacted in disappearance of delayed presentation with complications as seen by the number of cases diagnosed in neonatal period. Neonatal, perinatal, rarely antenatal detection of choledochal cysts was possible due to advances in imaging choledochal cysts. All children underwent excision of cyst and common hepaticodochojejunostomy. The safety of excision particularly when dealing inflamed, adherent choledochal cysts was better with open conventional excision. Similarly the confidence of handling the distal end was more with open surgery. Laparoscopy and Robot assisted have added another surgical access to choledochal cysts. Minimal access and magnification added to better visual appreciation, but ergonomics, cost, and availability, approach to distal end remain still to be validated. Conclusions: The present series clearly show the increase in the incidence of Choledochal cyst due to advances in imageology. Also has impacted early diagnosis is early surgical removal and there by delayed presentation, and with complications like stone, recurrent cholangitis, pancreatitis, biliary cirrhosis. This technological anatomical detailing has not reflected any significant change in the surgical management of Choledochal cyst. The advances in instrumentation and minimal access surgery and Robot assisted surgery still needs to validated as safe and can be used as standard surgical option for excision of choldochal cyst.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Choledochal cyst not an uncommon encountered pediatric surgical practices. Advances in technology have impacted timing of diagnosis. Advances in instrumentation and surgical access have added yet another way of excion. But the exact impact of early diagnosis on surgery of choledochal cysts have not been analysed and reported. Hence this attempt to analyse the three periods of choledochal cyst, namely 1. PTC (Percutaneous Trans-hepatic Cholangiography) and ERCP (Endoscopic Retrograde Cholangio Pancreatography), 2. USG (Ultrasonography) and CT Scan (Computerised Tomography era, and 3 .Period of MRCP (Magnetic Resonnace Cholangio Pancreaticography) with regards to impact of early diagnosis in the management of Choledochal cysts. Materials and Methods: A total of 205 cases of choledochal cysts treated by the team were analyzed. The data retrieval was from a self developed Microsoft Access based software used by senior pediatric surgeon. The parameter studied was actual impact on surgical aspects of the three main components of surgery of choledochal cysts, namely 1. Approach to cyst excision per se, 2. Management of distal end, 3. Restoration biliary drainage. Results: The advances in imageology have lead to early diagnosis and early surgery before complications develop. This has impacted in disappearance of delayed presentation with complications as seen by the number of cases diagnosed in neonatal period. Neonatal, perinatal, rarely antenatal detection of choledochal cysts was possible due to advances in imaging choledochal cysts. All children underwent excision of cyst and common hepaticodochojejunostomy. The safety of excision particularly when dealing inflamed, adherent choledochal cysts was better with open conventional excision. Similarly the confidence of handling the distal end was more with open surgery. Laparoscopy and Robot assisted have added another surgical access to choledochal cysts. Minimal access and magnification added to better visual appreciation, but ergonomics, cost, and availability, approach to distal end remain still to be validated. Conclusions: The present series clearly show the increase in the incidence of Choledochal cyst due to advances in imageology. Also has impacted early diagnosis is early surgical removal and there by delayed presentation, and with complications like stone, recurrent cholangitis, pancreatitis, biliary cirrhosis. This technological anatomical detailing has not reflected any significant change in the surgical management of Choledochal cyst. The advances in instrumentation and minimal access surgery and Robot assisted surgery still needs to validated as safe and can be used as standard surgical option for excision of choldochal cyst.
12.
Prasad, G. Raghavendra
In: International Journal of Phonosurgery & Laryngology, vol. 5, iss. 1, pp. 1-3, 2015, ISSN: 2230-7508.
@article{Prasad_2015,
title = {Congenital isolated agenesis of epiglottis presenting with acute life-threatening event successfully managed by temporary supraglottic closure and tracheostomy},
author = {G. Raghavendra Prasad},
url = {https://www.ijopl.com/doi/IJOPL/pdf/10.5005/jp-journals-10023-1092},
doi = {10.5005/jp-journals-10023-1092},
issn = {2230-7508},
year = {2015},
date = {2015-06-30},
urldate = {2015-06-30},
journal = {International Journal of Phonosurgery & Laryngology},
volume = {5},
issue = {1},
pages = {1-3},
abstract = {Isolated agenesis of epiglottis is extremely rare. The exact incidence is unknown. Anecdotal presentations associated with Pierre Robbin syndrome maxillary hypoplasia have been reported. Agenesis of epiglottis has also been published in an adult. Isolated agenesis of epiglottis with acute life-threatening event (ALTE) has not been specifically dealt with in the literature. Hence, this is the report of six contiguous cohort of isolated agenesis of epiglottis with ALTE. Materials and methods: After the first case of isolated agenesis of epiglottis was diagnosed 2 years ago, five more such cases were treated by the group. These formed the index cases of the cohort. Decision for surgery was based on an arbitrary 3 ALTEs in 24 hours. All the patients were initially intubated. Supraglottic space was closed using interrupted unabsorbable sutures. Tracheostomy was added. At 3 to 6 months of follow-up, glottis was restored by Nd-YAG laser knife. Five out of six children are alive and thriving well. One child died before he could be actively managed. Conclusion: Isolated agenesis of epiglottis with ALTE is extremely rare. Supraglottic closure saves lives and gives enough time for pharyngoesophageal coordination to develop.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Isolated agenesis of epiglottis is extremely rare. The exact incidence is unknown. Anecdotal presentations associated with Pierre Robbin syndrome maxillary hypoplasia have been reported. Agenesis of epiglottis has also been published in an adult. Isolated agenesis of epiglottis with acute life-threatening event (ALTE) has not been specifically dealt with in the literature. Hence, this is the report of six contiguous cohort of isolated agenesis of epiglottis with ALTE. Materials and methods: After the first case of isolated agenesis of epiglottis was diagnosed 2 years ago, five more such cases were treated by the group. These formed the index cases of the cohort. Decision for surgery was based on an arbitrary 3 ALTEs in 24 hours. All the patients were initially intubated. Supraglottic space was closed using interrupted unabsorbable sutures. Tracheostomy was added. At 3 to 6 months of follow-up, glottis was restored by Nd-YAG laser knife. Five out of six children are alive and thriving well. One child died before he could be actively managed. Conclusion: Isolated agenesis of epiglottis with ALTE is extremely rare. Supraglottic closure saves lives and gives enough time for pharyngoesophageal coordination to develop.
13.
Prasad, G. Raghavendra
Is it time to shift to total thyroidectomy for benign thyroid disease: an analysis of 77 redo thyroidectomies Journal Article
In: International Journal of Phonosurgery & Laryngology, vol. 5, iss. 1, pp. 4-6, 2015, ISSN: 2230-7508.
@article{Prasad_2015b,
title = {Is it time to shift to total thyroidectomy for benign thyroid disease: an analysis of 77 redo thyroidectomies},
author = {G. Raghavendra Prasad},
url = {https://www.ijopl.com/doi/IJOPL/pdf/10.5005/jp-journals-10023-1093},
doi = {10.5005/jp-journals-10023-1093},
issn = {2230-7508},
year = {2015},
date = {2015-05-31},
urldate = {2015-05-31},
journal = {International Journal of Phonosurgery & Laryngology},
volume = {5},
issue = {1},
pages = {4-6},
abstract = {Aims and objectives: To analyze redo thyroidectomies so as to get a possible answer to the controversy surrounding thyroidectomy for benign disease. Materials and methods: This is a retrospective observational cohort. From 1996 to 2010, a total 77 cases of redo thyroidectomies were performed. The data of all patients in
the department were maintained on a self developed MS access-based software. The data of redo thyroidectomies were reviewed. These patients were from five districts of Andhra Pradesh, 42 were women and 35 men, 51 underwent subtotal thyroidectomy, 21 had hemithyroidectomy and 5 patients had excision procedure; all were benign. The condition varied from multinodular goiter (MNG) and solitary nodule to follicular neoplasm. There were 44 right-sided, and 43 left-sided surgeries. Recurrence occurred in seven in less than 1 year, in 49 in less than 5 years, in 11 of them in less than 10 years and 10 had recurrence after 10 years. A total thyroidectomy was performed in all. Seventy-five had benign disease. Two had suspected neoplasm; one papillary and one Hurthle cell. One patient had transient recurrent laryngeal nerve palsy. Results: Seventy-seven redo surgeries for benign thyroid disease were performed. The high rate of referrals for recurrence
probably suggests inadequacy of subtotal and hemithyroidectomies for benign thyroid diseases. Conclusion: The present series of 77 redo thyroidectomies clearly suggests inadequacy of initial subtotal thyroidectomy.
Evidence-based analysis of complication rates and surgical feasibility supports total thyroidectomy as the complete safe, scientifically acceptable choice of primary surgical treatment for benign thyroid disease.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Aims and objectives: To analyze redo thyroidectomies so as to get a possible answer to the controversy surrounding thyroidectomy for benign disease. Materials and methods: This is a retrospective observational cohort. From 1996 to 2010, a total 77 cases of redo thyroidectomies were performed. The data of all patients in
the department were maintained on a self developed MS access-based software. The data of redo thyroidectomies were reviewed. These patients were from five districts of Andhra Pradesh, 42 were women and 35 men, 51 underwent subtotal thyroidectomy, 21 had hemithyroidectomy and 5 patients had excision procedure; all were benign. The condition varied from multinodular goiter (MNG) and solitary nodule to follicular neoplasm. There were 44 right-sided, and 43 left-sided surgeries. Recurrence occurred in seven in less than 1 year, in 49 in less than 5 years, in 11 of them in less than 10 years and 10 had recurrence after 10 years. A total thyroidectomy was performed in all. Seventy-five had benign disease. Two had suspected neoplasm; one papillary and one Hurthle cell. One patient had transient recurrent laryngeal nerve palsy. Results: Seventy-seven redo surgeries for benign thyroid disease were performed. The high rate of referrals for recurrence
probably suggests inadequacy of subtotal and hemithyroidectomies for benign thyroid diseases. Conclusion: The present series of 77 redo thyroidectomies clearly suggests inadequacy of initial subtotal thyroidectomy.
Evidence-based analysis of complication rates and surgical feasibility supports total thyroidectomy as the complete safe, scientifically acceptable choice of primary surgical treatment for benign thyroid disease.
the department were maintained on a self developed MS access-based software. The data of redo thyroidectomies were reviewed. These patients were from five districts of Andhra Pradesh, 42 were women and 35 men, 51 underwent subtotal thyroidectomy, 21 had hemithyroidectomy and 5 patients had excision procedure; all were benign. The condition varied from multinodular goiter (MNG) and solitary nodule to follicular neoplasm. There were 44 right-sided, and 43 left-sided surgeries. Recurrence occurred in seven in less than 1 year, in 49 in less than 5 years, in 11 of them in less than 10 years and 10 had recurrence after 10 years. A total thyroidectomy was performed in all. Seventy-five had benign disease. Two had suspected neoplasm; one papillary and one Hurthle cell. One patient had transient recurrent laryngeal nerve palsy. Results: Seventy-seven redo surgeries for benign thyroid disease were performed. The high rate of referrals for recurrence
probably suggests inadequacy of subtotal and hemithyroidectomies for benign thyroid diseases. Conclusion: The present series of 77 redo thyroidectomies clearly suggests inadequacy of initial subtotal thyroidectomy.
Evidence-based analysis of complication rates and surgical feasibility supports total thyroidectomy as the complete safe, scientifically acceptable choice of primary surgical treatment for benign thyroid disease.
2013
14.
Nori, Madhavi; Venkateshwarlu, Jampala; Vijaysekhar,; Prasad, G. Raghavendra
Extrahepatic biliary atresia with choledochal cyst: prenatal MRI predicted and post natally confirmed: a case report Journal Article
In: Indian Journal of Radiology and Imaging, vol. 23, iss. 3, pp. 238-242, 2013, ISSN: 0971-3026.
@article{Nori_2013,
title = {Extrahepatic biliary atresia with choledochal cyst: prenatal MRI predicted and post natally confirmed: a case report},
author = {Madhavi Nori and Jampala Venkateshwarlu and Vijaysekhar and G. Raghavendra Prasad},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843332/pdf/IJRI-23-238.pdf},
issn = {0971-3026},
year = {2013},
date = {2013-08-31},
urldate = {2013-08-31},
journal = {Indian Journal of Radiology and Imaging},
volume = {23},
issue = {3},
pages = {238-242},
abstract = {Extrahepatic biliary atresia (EHBA) is an uncommon cause of neonatal jaundice. Antenatal Magnetic Resonance Imaging (MRI) diagnosis of EHBA has not been published to the best of our knowledge till date. EHBA with cystic component is likely to be mistaken for choledochal cyst. A case that was antenatally predicted and postnatally confirmed by surgery and histopathology is being reported. All imaging signs are analyzed herewith. Imaging helps in the prediction of EHBA and also helps in early postnatal surgical referral which in turn improves the results of Kasai’s portoenterostomy.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Extrahepatic biliary atresia (EHBA) is an uncommon cause of neonatal jaundice. Antenatal Magnetic Resonance Imaging (MRI) diagnosis of EHBA has not been published to the best of our knowledge till date. EHBA with cystic component is likely to be mistaken for choledochal cyst. A case that was antenatally predicted and postnatally confirmed by surgery and histopathology is being reported. All imaging signs are analyzed herewith. Imaging helps in the prediction of EHBA and also helps in early postnatal surgical referral which in turn improves the results of Kasai’s portoenterostomy.