Surgery
(RRJoS)ISSN 2349-3712Jan - April 2014
STM JOURNALSScientific Technical Medical
Research & Reviews Journal of
Ÿ A Comparative Study of DGHAL using RAR with Open Haemorrhoidectomy for Treatment of Grade III and IV
Haemorrhoids
Ÿ A Comparative Study of MVA vs. EVA in Pregnancy Termination upto 10 Weeks of Gestation
Ÿ Arnold Chiari Type 1 Malformation: A Case Report
Ÿ Calcified Ovarian and Uterine Fibroid- A Rare Occurrence: Case Report
Ÿ Madura Foot in Female - A Case Report
Ÿ Medical Management of Benign Prostatic Hyperplasia
Ÿ Study of Blunt Traumatic Abdominal Solid Organ Injuries with Special Reference to Non-operative Management
Ÿ Giant Cell Tumour of Tendon Sheath in Thumb: A Case Report
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Research & Reviews : Journal of Surgery
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Industrial Tribology Machine Dynamics & Maintenance
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Dr. Shankargouda PatilAsst. Prof., Department of Oral
Pathology, KLE Society's Institute of Dental Sciences, Bangalore, India.
Prof. Subash Chandra MishraProfessor, Metallurgical & Materials
Engineering Department, NIT, Rourkela, India.
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Chandigarh, India.
STM Journal (s) Advisory Board & Editorial Board
Dr. Somprakas Basu Associate Professor Department of
General Surgery, Institute of Medical Sciences, Banaras Hindu University,
Varanasi India.
Anand KumarProfessor of General Surgery Department of General Surgery, Institute of Medical
Sciences, Banaras Hindu University, Varanasi India.
Dr. Vivek KumarConsultant Plastic & Cosmetic Surgeon
Sir Ganga Ram Hospital, New Delhi India.
Dr. Maneesh Singhal Associate Professor, Departmet of
Surgery, AIIMS Delhi, India.
I take the privilege to present the hard copy compilation for the [Volume 3 Issue (1)] of Research &
Reviews: Journal of Surgery. The intension of RRJoS is to create an atmosphere that stimulates
creativeness, research and growth in the area of Surgery.
The development and growth of the mankind is the consequence of brilliant Research done by
eminent Scientists and Engineers in every field. RRJoS provides an outlet for Research findings and
reviews in areas of Surgery found to be relevant for National and International recent developments
& research initiative.
The aim and scope of the Journal is to provide an academic medium and an important reference for
the advancement and dissemination of Research results that support high level learning, teaching and
research in the domain of Surgery.
Finally, I express my sincere gratitude and thanks to our Editorial/ Reviewer board and Authors for
their continued support and invaluable contributions and suggestions in the form of authoring write-
ups/ reviewing and providing constructive comments for the advancement of the journals. With
regards to their due continuous support and co-operation, we have been able to publish quality
Research/Reviews findings for our customers base.
I hope you will enjoy reading this issue and we welcome your feedback on any aspect of the Journal.
Dr. Archana Mehrotra
Director
STM Journals
Director's Desk
STM JOURNALS
1. A Comparative Study of DGHAL using RAR with Open Haemorrhoidectomy for Treatment of Grade III and IV Haemorrhoids Sunil Agrawal, Brijesh Kumar Singh, Gaurav Kumar Nirwal 1
2. A Comparative Study of MVA vs. EVA in Pregnancy Termination upto 10 Weeks of Gestation Priti Anand, Mukul Bindra, Sadhna Mathur, Ravi Mathur 6
3. Arnold Chiari Type 1 Malformation: A Case ReportSunil Agarwal, Sameer Gupta, Gaurav Kumar Nirwal, Abhay Setia 11
4. Calcified Ovarian and Uterine Fibroid- A Rare Occurrence: Case ReportMukul Bindra, Priti Anand, Sadhna Mathur, Ravi Mathur 14
5. Madura Foot in Female - A Case ReportSiddaram Patil, Sankar Rao. P 18
6. Medical Management of Benign Prostatic Hyperplasia Ravi Kumar Mathur, Brijesh Kumar Singh, Vansh Gopal Yadav, Iqbal Singh 23
7. Study of Blunt Traumatic Abdominal Solid Organ Injuries with Special Reference to Non-operative Management
Dr. S.P. Singh, Dr. Anil Kumar Yadav 26
8. Giant Cell Tumour of Tendon Sheath in Thumb: A Case Report Sankar Rao P, Siddaram Patil, Sandeep Reddy 30
ContentsResearch & Reviews : Journal of Surgery
RRJoS (2014)© STM Journals 2014. All Rights Reserved
Research & Reviews: Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
A Comparative Study of DGHAL using RAR with Open
Haemorrhoidectomy for Treatment of Grade III and IV
Haemorrhoids
Sunil Agrawal*, Brijesh Kumar Singh, Gaurav Kumar Nirwal Department General Surgery, NIMS, Jaipur, Rajasthan, India
Abstract Hemorrhoids are the most common anal disease and many modalities are available for
its treatment. In our study, we compared Doppler-guided Hemorrhoid Artery Ligation
combined with Recto Anal Repair and open Hemorrhoidectomy. Study conducted on 50
patients with Grade III and Grade IV haemorrhoids. We observed Doppler Guided Haemorrhoidal Artery Ligation (DGHAL) procedure has less post-operative pain, less
need for analgesic, less operative time and more patient satisfaction. DGHAL with RAR
is safe and easy method for treating hemorrhoids.
Keywords: Hemorrhoids, Doppler-Guided Hemorrhoid Artery Ligation, Recto anal
Repair, Hemorrhoidectomy
RRJoS (2014)© STM Journals 2014. All Rights Reserved
Research & Reviews : Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
A Comparative Study of MVA vs. EVA in Pregnancy
Termination upto 10 Weeks of Gestation
Priti Anand*, Mukul Bindra, Sadhna Mathur, Ravi Mathur
NIMS Medical College & Hospital Shobha Nagar, Jaipur-Delhi Highway (NH-11C),
Jaipur, Rajasthan, India
Abstract We share our research project, undertaken by a small institutional study group lead by
myself, towards completion of my specialist training program of Masters in Obstetrics &
Gynaecology. The study was undertaken after due approval. This study is motivated and
is based on set of previous studies done in various institutions of excellence, worldwide
and may resemble to some study results published elsewhere. However, due credit has been given to the said published results in our study. The motive of the study was “A
comparative study of manual vacuum aspiration and electric vacuum aspiration in pregnancy termination upto 10 weeks of gestation”.
Keywords: Manual vacuum aspiration, Electric vacuum aspiration, Pregnancy termination
RRJoS (2014)© STM Journals 2014. All Rights Reserved
Research & Reviews: Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Arnold Chiari Type 1 Malformation: A Case Report
Sunil Agarwal*, Sameer Gupta, Gaurav Kumar Nirwal, Abhay Setia Department of general surgery, National Institute of Medical Science, Jaipur, India
Abstract Arnold Chiari malformation is neurological disorder in which there is down ward
displacement of cerebellar tonsil through the foramen magnum. We are reporting a case of a 35-year-old woman with Arnold Chiari malformation Type - 1. Our patient
presented with the history of headache for 1 month, pain right upper limb for 15 days.
Pre-operative MRI was done to confirm the diagnosis. Patient was operated &
discharged in 8 days.
Keywords: Arnold Chiari malformation, neurological disorder, foramen magnum
RRJoS (2014) © STM Journals 2014. All Rights Reserved
Research & Reviews: Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Calcified Ovarian and Uterine Fibroid- A Rare
Occurrence: Case Report
Mukul Bindra, Priti Anand*, Sadhna Mathur, Ravi Mathur
NIMS Medical College & Hospital. Shobha Nagar, Jaipur-Delhi Highway (NH-11C),
Jaipur, Rajasthan-India
Abstract In this paper we present a case report of female who presented with a non-functioning large ovarian fibroid with extensive calcification with uterine fibroid in a peri
menopausal age. Fibromas belong to a spectrum of benign ovarian tumor and are the most common sex cord tumor. Total abdominal hysterectomy with bilateral salpingo
oophorectomy was done as the patient was not desirous of future fertility. Histopathology
showed multiple uterine fibroids with extensive calcification along with calcified left ovarian fibroid.
Keywords: Fibroma, Uterine fibroid, Meig’s syndrome
RRJoS (2014)© STM Journals 2014. All Rights Reserved
Research & Reviews : Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Madura Foot in Female - A Case Report
Siddaram Patil*, Sankar Rao. P Mamata Medical College, Rotary Nagar, Khammam, Andhra Pradesh, India
Abstract Mycetoma is a chronic, localized, slowly progressing infection of the cutaneous and
subcutaneous tissues caused either by fungi (eumycetoma or implantation mycosis) or by aerobic actinomycetes (actinomycetoma). It is acquired by traumatic implantation, most
commonly in the tropics and subtropics, especially in rural agricultural communities,
though well recognized elsewhere in Asia. A 48 year-old male agricultural laborer and
rice farmer from khammam district andhrapradesh india was admitted to Mamata
general hospital khammam ap, with a swelling on his both ankles, without a history of
trauma. Pt has discharging sinus.The swelling had progressed slowly but painlessly over 2 years. Ten days before admission the foot had increased considerably in size and
became very painful, preventing her from walking. Gram stain and bacterial culture of tissue biopsies revealed a branching filamentous Gram-positive bacterium that was
subsequently identified as Actinomadura madurae. She was treated with long-term co-
trimoxazole and multiple 3-week cycles of amikacin with a good therapeutic response. We report the patient with actinomycetoma from Khammam. The disease should be
considered in the differential diagnosis of chronic skin and bone infections in patients
from rural SE Asia.
Keywords: Mycetoma, Madura foot, Actinomadura madurae
RRJoS (2014)© STM Journals 2014. All Rights Reserved
Research & Reviews : Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Medical Management of Benign Prostatic Hyperplasia
Ravi Kumar Mathur, Brijesh Kumar Singh*, Vansh Gopal Yadav, Iqbal Singh NIMS Medical College, Jaipur, Rajasthan, India
Abstract Benign prostatic hyperplasia is one of the most prevalent diseases in elderly men.
Medical therapies are targeted to relieve obstruction by relaxing smooth muscles(α-blocker) or promoting regression of the disease process (androgen ablation).Three major
classes of drugs have been used for the medical management of BPH are α-adrenergic
receptor antagonist, hormones and phytotherapy. Selective α 1 receptor antagonist is
effective in the treatment of BPH. The development of specific α receptor antagonist such
as tamsulosin with long half-life and no effect on blood pressure may offer improved
tolerability over other selective α receptor antagonists.
Keywords: Hyperplasia, prostatic, adreno receptors
RRJoS (2014) © STM Journals 2014. All Rights Reserved
Research & Reviews: Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Study of Blunt Traumatic Abdominal Solid Organ
Injuries with Special Reference to Non-operative
Management
Dr. S.P. Singh1*, Dr. Anil Kumar Yadav
2
1NIMS Medical College, Jaipur, Rajasthan, India
2SMS Medical College and Hospital, Jaipur, Rajasthan, India
Abstract With increasing number of motor vehicles, the incidence of Blunt Trauma Abdomen
(BTA) is on the rise. It has been posing severe threat to mobile population of society.
With paucity of specialized trauma centers at primary and secondary level hospitals, BTA is either missed or delayed or is over enthusiastically treated by operative intervention in
all cases, thereby increasing morbidity and mortality. The aim is to evaluate the criteria for Operative or Non-Operative Management (NOM) and to review Conservative Line of
Management. This is a prospective hospital based study, conducted at Department of
General Surgery, SMS Medical College Hospital, Jaipur (Rajasthan) from 2010 to 2012. A total of 100 patients were studied. Hemodynamically unstable and hollow viscous
injury patients were excluded from study. After thorough clinical examination, patients
were subjected to Focused Abdominal Trauma Sonography (FAST) and CECT, a decision of conservative or operative management was taken. The results show that 75%
patients of BTA were of the age group of 21–40 years, of these, 83% patients were males. 90% patients presented with pain abdomen and 56% with distension. FAST and CECT
revealed 51% had spleen, 44% liver, 14% kidney and 4% pancreas injury. 61% patients
were treated by NOM without any mortality whatsoever. Only five patients had respiratory and intra-abdominal infection. Out of 39% patients of operative group,
33.33% developed wound infection, 12.8% had respiratory infection followed by 2.56% abdominal infection and dehiscence each. Total 14% patient died in this study, of these
6% died at initial resuscitation, 6% died post operatively due to massive abdominal
trauma and 2% died due to associated head injury. NOM had a better outcome in BTA patients if properly and repeatedly evaluated by clinical examination, FAST and CECT
with no mortality in the series.
Keywords: Blunt Abdominal Trauma, Non-Operative Management, Focused
Abdominal Sonography for Trauma, Road Traffic Accident
RRJoS(2014)© STM Journals 2014. All Rights Reserved
Research & Reviews: Journal of Surgery ISSN: 2349-3712
Volume 3, Issue 1
www.stmjournals.com
Giant Cell Tumour of Tendon Sheath in
Thumb: A Case Report
Sankar Rao P, Siddaram Patil*, Sandeep Reddy Mamata Medical College, Department of Orthopaedic, Rotary Nagar, Khammam,
Andhra Pradesh, India
Abstract Giant cell tumor of the tendon sheath is the second most common tumor of the hand often referred to as xanthoma. Histologically these tumors are composed of multinucleated
giant cells, polyhedral histiocytes, fibrosis and hemosiderin deposits. Marginal excision
of giant cell tumor of the tendon sheath is the treatment of choice. We present a case of Xanthoma of flexor pollicis longus tendon that presented as single enlarging mass in
volar aspect of left thumb. After clinical diagnosis work up is done with ultrasound,
FNAC and excision biopsy.
Keywords: Thumb, tendon sheath, giant cell tumor, flexor tendon