Publications by authors named "Rajgopal Shenoy"

24 Publications

  • Page 1 of 1

Application of Topical Oxygen Therapy in Healing Dynamics of Diabetic Foot Ulcers - A Systematic Review.

Rev Diabet Stud 2019 30;15:74-82. Epub 2019 Dec 30.

Department of Surgery, Kasturba Medical College and Kasturba Hospital, Manipal Academy of Higher Education (MAHE), Madhav Nagar, Manipal 576104, Karnataka, India.

Background: Individuals with diabetes may develop diabetic foot ulcers due to diabetic peripheral neuropathy. Multiple factors influence the ulcer healing process; oxygen helps in facilitating the different stages of wound healing.

Objective: The objective of this systematic review was to analyze the different levels of evidence available in the application of topical oxygen therapy, warm oxygen therapy, or other modes of topical oxygen delivery in the healing dynamics of diabetic foot ulcers.

Methods: Databases searched included Pubmed/Medline, Science Direct, Web of Science, Scopus, Cochrane, and CINAHL. The eligibility criteria of studies included participants ≥18 years with chronic non-healing diabetic foot ulcer (duration ≥3 months) receiving warm oxygen or topical oxygen therapy (TOT), and other modes of topical oxygen administration, which were compared with standard care group. Randomized and non-randomized studies were included. The primary outcome measure assessed was the rate of wound healing or wound closure.

Results: The review included 5 studies which used different modes of topical oxygen administration. The healing trajectory of the wounds was completely achieved in low-grade ulcers (grade 1), whereas all high-grade ulcers (grades 2, 3, and above) showed either 100% or 50% healing with a reduction in ulcer size and ulcer tissue depth.

Conclusion: Topical oxygen therapy facilitates wound healing dynamics among individuals with chronic diabetic foot ulcers.
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http://dx.doi.org/10.1900/RDS.2019.15.74DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946089PMC
July 2020

Photobiomodulation therapy in neuroischaemic diabetic foot ulcers: a novel method of limb salvage.

J Wound Care 2018 12;27(12):837-842

Assistant Professor-Senior Scale, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Objective: Low-level laser therapy (also known as photobiomodulation therapy, PBMT) promotes accelerated healing of diabetic foot ulcers (DFUs), thereby preventing the risk of future complications and amputation. The aim of this study was to determine the effect of PBMT, with structured, graded mobilisation and foot care, on DFU healing dynamics.

Method: Patients diagnosed with type 2 diabetes, diabetic peripheral neuropathy and presenting with a chronic neuroischaemic DFU, were treated with PBMT using scanning and non-contact probe methods. The DFU was clinically observed and the area measured every seven days until complete healing. Neuropathic parameters were also measured. The PBMT was administered until complete closure of the DFU and patients also undertook a programme of graded mobilisation.

Results: A total of 17 participants were recruited, with a mean age of 69±8 years, and a mean duration of diabetes of 13±5 years. Mean complete closure time was 26±11days. In addition, a mean reduction of the semi-quantitative vibration pressure threshold from 49±2 volts to 20±4 volts was observed in all participants.

Conclusion: PBMT can be effectively used as a treatment mode for neuroischaemic DFUs in patients with type 2 diabetes. Graded mobilisation with focused foot care could improve the function of people living with type 2 diabetes with a chronic DFU.
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http://dx.doi.org/10.12968/jowc.2018.27.12.837DOI Listing
December 2018

Hard nodular lesions over the chest wall.

J Fam Pract 2016 Jan;65(1):53-5

Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

Thirteen years after undergoing a mastectomy for breast cancer, this patient developed lesions near the scar.
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January 2016

Primary cutaneous rhinosporidiosis: an unusual lesion with an unusual presentation.

BMJ Case Rep 2015 Apr 1;2015. Epub 2015 Apr 1.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

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http://dx.doi.org/10.1136/bcr-2015-209596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401973PMC
April 2015

Adenocarcinoma of the duodenojejunal flexure presenting as a stricturous lesion.

BMJ Case Rep 2014 May 19;2014. Epub 2014 May 19.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 50-year-old woman was referred with a colicky upper abdominal pain of 3 months duration. She experienced an increase in pain 2 weeks prior to presentation. This was associated with bilious vomiting about 5-6 times/day with no change in bowel habits. She had no history of any abdominal pathology. A review of systems showed she had a weight loss of 20 kg over a period of 4 months with recent onset of loss of appetite. Physical examination revealed a soft distended upper abdomen with non-radiating pain in the epigastrium. CT of the abdomen showed a heterogeneously enhancing stricturous growth in the proximal part of the jejunum with gross dilation of the stomach and duodenum. She underwent resection and anastomosis of the proximal jejunum. Histopathology revealed the lesion to be an adenocarcinoma.
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http://dx.doi.org/10.1136/bcr-2013-200546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039815PMC
May 2014

Be Careful with an IV Line.

J Clin Diagn Res 2014 Mar 15;8(3):166-7. Epub 2014 Mar 15.

Intern, Department of Surgery, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .

Obtaining an intravenous (IV) access is a simple procedure which can be done in almost any hospital setting. One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra-arterially, which can potentially lead to life altering consequences. In the hope that these types of events can be prevented, we are presenting a case of a 57-year-old male who underwent bougie dilatation for an oesophageal stricture and was accidentally given medication for pain management intra-arterially through an improperly placed IV line, which resulted in ischaemia, gangrene and subsequent loss of the hand. Those who try to obtain an IV access should always be on the lookout for possible clues that can prevent an inadvertent IA injection, especially if cannulation is in an area where an artery is in close proximity to a vein; these clues include but are not limited to the following: a bright-red flash of blood in the cannula, pulsatile movement of blood in the IV line, and intense pain or burning at the site of injection. These signs, as well as educating the patient on early symptoms of ischaemia, may allow early action to be taken, to prevent irreparable damage. We always have to be careful when we insert an I.V line.
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http://dx.doi.org/10.7860/JCDR/2014/7937.4150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003627PMC
March 2014

Primary colonic signet ring cell carcinoma in a young patient.

BMJ Case Rep 2014 Mar 20;2014. Epub 2014 Mar 20.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 28-year-old woman presented with colicky abdominal pain for 3 months. Pain was associated with episodes of vomiting, abdominal distension and constipation. She also had loss of weight for this duration. General physical examination was unremarkable and the abdomen was soft, with no palpable organomegaly. A CT of the abdomen showed small bowel and ascending colon dilation with multiple air fluid levels. There was also a short segment of circumferential bowel wall thickening and luminal narrowing in the hepatic flexure with sudden transition of bowel diameter. She underwent a right hemicolectomy after necessary preoperative investigations. Histopathology revealed signet ring cell carcinoma (SRCC). This case highlights the importance of detecting such a lesion in a young, otherwise fit woman. The challenge lies in early diagnosis and awareness of general practitioners about this aggressive form of colonic tumours.
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http://dx.doi.org/10.1136/bcr-2013-200587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962910PMC
March 2014

Symmetrical peripheral gangrene-a case report and brief review.

Indian J Surg 2013 Jun 16;75(Suppl 1):163-5. Epub 2012 Jun 16.

Department of Surgery, Kasturba Hospital, Manipal, India.

A 30 year-old gentleman presented to casualty with history of pain abdomen for six days, fever and decreased urine output since two days. He was in a state of septic shock and was diagnosed to have intestinal perforation. His peripheral pulses were not palpable except for the femoral and brachial vessels. Despite fluid resuscitation, he needed infusion of high doses of dopamine and noradrenaline to maintain his blood pressure. He was operated for repair of perforation. On the first postoperative day, in the intensive care unit, vasopressin infusion was added in view of persistent hypotension. Appropriate fluid resuscitation and antibiotic therapy helped to wean him off inotropes and vasopressors by the second postoperative day. On the 3rd postoperative day, however, the patient developed discolouration and blebs on the fingers of left hand, followed by the right hand and then both the lower limbs. Subsequently, over a period of 10 days, this progressed to gangrene formation in the hands despite the patient being haemodynamically stable without any inotropes or vasopressors in this period. We conclude that the septic shock is a systemic derangement affecting all organ systems including coagulation and microcirculation. Early recognition and prompt management of sepsis, optimisation of fluid status to wean off the inotropes and vasopressors at the earliest is necessary to avoid catastrophes such as symmetrical peripheral gangrene.
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http://dx.doi.org/10.1007/s12262-012-0576-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693354PMC
June 2013

Primary mesenteric fibromatosis: a case report with brief review of literature.

Indian J Surg 2013 Jun 1;75(Suppl 1):131-3. Epub 2012 Jun 1.

Department of Surgery, Kasturba Medical College Hospital, Manipal University, Manipal, Karnataka India 576104.

Although fibromatosis of the mesentery is a very rare locally aggressive benign condition, the uncertain treatment modalities, the natural history of the disease, and the other common differential diagnosis of the condition along with inexperience of the general clinicians with this disease pose a challenge to the professionals. The prolonged periods of stability and even regression in size of the tumor offer a hope for treatment. Accounting for 0.03 % of all neoplasms, it is also known as deep fibromatosis and desmoid tumor. Here, we discuss one case of primary mesenteric fibromatosis in a young male patient who presented to us with chronic abdominal pain after he was treated for acid peptic disease for the same at a local hospital. This case shows how management of this disease can be delayed due to unfamiliarity among clinicians of this condition. In our patient, a palliative surgical management plan was undertaken due to symptomatic mass in the abdomen, owing to unresectability.
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http://dx.doi.org/10.1007/s12262-012-0515-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693259PMC
June 2013

Pancreatic cancer presenting as a Sister Mary Joseph's nodule.

BMJ Case Rep 2013 Nov 29;2013. Epub 2013 Nov 29.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 69-year-old man presented with a painful umbilical nodule of 1 month duration. On examination the nodule was blackish in colour with a serous discharging fluid and was 2×2 cm in size, tender and fixed to the skin. There were no scars or sinuses at the umbilicus and no palpable mass or organomegaly on systemic examination. The patient underwent wide local excision of the skin nodule and on histopathology was reported as metastatic adenocarcinoma of the skin. A CT of the abdomen was performed to look for the primary site, which showed a 5×4 cm lesion in the tail of the pancreas. A biopsy from the pancreatic lesion was taken which was reported as an adenocarcinoma. CA19-9 was more than 1000 U/mL. The patient was advised palliative chemotherapy with gemcitabine. He was unwilling to take any further treatment in view of the advanced nature of the disease.
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http://dx.doi.org/10.1136/bcr-2013-201020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847646PMC
November 2013

Primary perineal hernia: a differential diagnosis for Bartholin's cyst in women.

ANZ J Surg 2014 Sep 29;84(9):686-7. Epub 2013 Oct 29.

Department of Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

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http://dx.doi.org/10.1111/ans.12265DOI Listing
September 2014

Endometriosis of extra-pelvic round ligament, a diagnostic dilemma for physicians.

BMJ Case Rep 2013 Aug 19;2013. Epub 2013 Aug 19.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 49-year-old multiparous woman presented with a swelling in the left groin of 6 months duration. The swelling was associated with a dull aching pain. The patient reported increase in size of the swelling during lifting of heavy weights. Menstrual history was normal and there was no increase in pain over the swelling during menstruation. She underwent a caesarean section 20 years ago and the scar had healed by primary intention. She was provisionally diagnosed to have a left-sided inguinal hernia. Ultrasonography showed a multiloculated cyst measuring 5.3×1.5×5.2 cm within the inguinal canal. The patient had excision of the cyst under spinal anaesthesia. Intraoperatively the cyst was found to arise from the left round ligament. It measured 7×6 cm extending to the left lateral vaginal wall. Histopathology revealed endometriosis of the round ligament. Her gynaecological assessment was normal and they recommended no further treatment. On follow-up the patient was asymptomatic and wound had healed well.
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http://dx.doi.org/10.1136/bcr-2013-200465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762512PMC
August 2013

Aggressive fibromatosis (desmoid tumour) of the head and neck: a benign neoplasm with high recurrence.

BMJ Case Rep 2013 Jun 28;2013. Epub 2013 Jun 28.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 50-year-old man presented with a 5-month history of swelling over the right side of neck. The swelling was associated with dull aching pain radiating to the forearm without associated weakness of upper extremity or sensory loss. There was no history of trauma. On examination a fixed mass approximately 8×6 cm in size, smooth, firm in consistency, with ill-defined margins was present in the right posterior triangle. MRI scan of the neck revealed well-defined, lobulated, heterogeneously enhancing altered signal intensity mass at the root of neck. Debulking of the tumour was performed in view of its close proximity to the brachial plexus. Histopathology revealed aggressive fibromatosis (AF). AF is a benign fibrous neoplasm arising from fascia, periosteum and musculoaponeurotic structures of the body. AF in the head and neck region tends to be locally aggressive with a nature to invade bone and soft tissue structures.
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http://dx.doi.org/10.1136/bcr-2013-200156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703068PMC
June 2013

Jejuno-jejunal intussusception: an unusual complication of feeding jejunostomy.

BMJ Case Rep 2013 Jun 27;2013. Epub 2013 Jun 27.

Kasturba Medical College, Manipal, Karnataka, India.

The jejuno-jejunal intussusception is a rare complication of jejunostomy tube placement. We are reporting a case of 33-year-old man who was suffering from absolute dysphagia due to carcinoma of cricopharynx with advanced metastatic disease, who underwent Stamms feeding jejunostomy as a part of palliative care. After 1 month he presented with colicky type of pain in the abdomen and vomiting. Sonogram of abdomen revealed a target sign and a feeding tube in a dilated jejunum. Abdominal CT proved the sonographic impression of jejuno-jejunal intussusception. He, therefore, underwent exploratory laparotomy and resection and anastomosis of the intussuscepted bowel. New feeding jejunostomy (FJ) was done distally from the anastomotic site. As per the literature this complication has been reported in Witzels jejunostomy. In our case the patient had undergone Stamms jejunostomy with placement of a Ryle's tube. Intussusception should be considered if a patient comes with abdominal pain and vomiting following FJ.
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http://dx.doi.org/10.1136/bcr-2013-200219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703069PMC
June 2013

Rhabdomyosarcoma of spermatic cord in a 65-year-old man presenting as a groin swelling.

BMJ Case Rep 2013 Jun 24;2013. Epub 2013 Jun 24.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 65-year-old man presented with a swelling in the right groin of 6 months duration. The swelling was associated with dull aching pain and the patient reported of increase in size of the swelling during lifting of heavy weights. The swelling was 6×5 cm, hard in consistency, mobile and there was no impulse of cough. Ultrasonography showed a solid mass measuring 5.3×1.5×5.2 cm arising from the spermatic cord. High-inguinal orchiectomy was performed. Histopathology revealed rhabdomyosarcoma (RMS) of the spermatic cord. Patient was advised adjuvant chemotherapy but he refused. Spermatic cord RMS is a rare tumour derived from the undifferentiated mesoderm. It is most often observed in children and adolescents. It rarely appears after the second decade of life. It usually manifests as a painless, firm to hard mass in the inguinal canal or scrotum. Radical high-inguinal orchiectomy is the treatment of choice.
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http://dx.doi.org/10.1136/bcr-2013-010499DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703094PMC
June 2013

Iliac crest bone graft donor site hernia: not so uncommon.

BMJ Case Rep 2013 Jun 12;2013. Epub 2013 Jun 12.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

A 73-year-old man, who had undergone fracture fixation of humerus with LCP plating and bone grafting, presented again with a peri-implant fracture after 1 year. A repeat surgery was contemplated and replating was performed with tricortical bone graft harvested from the iliac crest. In the postoperative period the patient developed a tender swelling at the graft site with nausea and abdominal discomfort. It was managed conservatively thinking it to be a haematoma at the graft site. In the following 2 days his symptoms worsened. A CT abdomen showed the herniation of caecum from the bone graft donor site with obstruction. The patient was taken up for emergency surgical repair, the caecum was reduced and polypropylene mesh hernioplasty was performed. The patient recovered well without recurrence in the follow-up period. Iliac crest bone graft site hernia is not so uncommon and care has to be taken while harvesting.
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http://dx.doi.org/10.1136/bcr-2013-010386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702860PMC
June 2013

Extragenital aggressive angiomyxoma of the axilla and the chest wall.

J Clin Diagn Res 2013 Apr 12;7(4):718-20. Epub 2013 Feb 12.

Assistant Professor, Department of Pathology, KMC, Manipal University , Manipal, India .

Aggressive angiomyxomas are uncommon mesenchymal tumours which most often arise in the perineal and the pelvic regions in women. Extragenital aggressive angiomyxonas are extremely rare. We are reporting a young male with an aggressive angiomyxoma which involved the axillary region and extended into the anterior chest wall, which demonstrated its characteristic histomorphological features. The diagnosis was confirmed by immunohistochemistry. A careful histological examination, along with immunohistochemistry, aids in diagnosing this lesion and differentiating it from tumours which have similar histologies.
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http://dx.doi.org/10.7860/JCDR/2013/5458.2891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644454PMC
April 2013

A brief review of common oral premalignant lesions with emphasis on their management and cancer prevention.

Indian J Surg 2011 Aug 28;73(4):256-61. Epub 2011 Apr 28.

Unlabelled: Long-term outcomes associated with oral cancer and its management over the past several decades has caused concern and the value of mass oral cancer screenings has come under scrutiny. Though not all oral carcinomas are preceded by premalignant lesions as clinically visible morphological alterations occur secondary to the cellular or molecular changes, certain high risk lesions have been identified. Their management remains controversially polarized between surgical excision to prevent malignant change and conservative medical or surveillance techniques. Though oral cancer is one of the "major killers" of modern times, there seem to be no widely accepted criteria for decision making in clinical practice, the evidence base is scanty and uncertainty persists throughout investigation, diagnosis, and treatment. In this article, we have briefly discussed the common premalignant lesions, with an emphasis on their evidence based management and prevention.

Electronic Supplementary Material: The online version of this article (doi:10.1007/s12262-011-0286-6) contains supplementary material, which is available to authorized users.
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http://dx.doi.org/10.1007/s12262-011-0286-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144354PMC
August 2011

Enteral feeding by fistuloclysis in a midjejunal fistula.

Indian J Gastroenterol 2005 May-Jun;24(3):124-5

Department of Surgery, Kasturba Medical College, Manipal, Udupi Dist, Karnataka, India.

Enterocutaneous fistulas are potentially life-threatening complications of gastrointestinal surgery. Nutritional support is the mainstay of management. We report a 32-year-old man who developed an enterocutaneous fistula following surgery for ulcerative colitis. Enteral feeding was attempted by introducing a Foley's catheter through the midjejunal fistula.
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October 2005

Segmental jejunal lipomatosis--a rare cause of intestinal obstruction.

Yonsei Med J 2003 Apr;44(2):359-61

Professor of Surgery, Kasturba Medical College and Hospital, Manipal 576 119, Karnataka, India.

A rare case of a segmental small intestinal (jejunal) lipomatosis is described. A 33-year-old male was admitted with a clinical diagnosis of an acute intestinal obstruction. A plain erect abdominal x-ray showed multiple air-fluid levels. On an exploratory laparotomy, a jejunojejunal intussusception was found secondary to a segmental submucosal lipomatosis. This was treated by a segmental resection and anastomosis, which resulted in a complete cure. Here we present this case with a review of the relevant literature.
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http://dx.doi.org/10.3349/ymj.2003.44.2.359DOI Listing
April 2003

Upper gastrointestinal bleeding in tropical pancreatitis due to pseudoaneurysm rupture.

Trop Doct 2003 Jan;33(1):57

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India 576119.

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http://dx.doi.org/10.1177/004947550303300128DOI Listing
January 2003

Colonic pseudo-obstruction due to herpes zoster.

Indian J Gastroenterol 2002 Sep-Oct;21(5):203-4

Department of General Surgery, Kasturba Medical College and Hospital, Manipal, Karnataka.

Visceral motor complications are uncommon manifestations of herpes zoster (varicella zoster). We report a 59-year-old man who developed acute colonic pseudo-obstruction, which followed the appearance of dermatomal herpes zoster.
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November 2002
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