Gabriel Rodrigues

Manipal University, Udupi, Karnātaka, India

Are you Gabriel Rodrigues?

Claim your profile

Publications (31)10.38 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Reliability of serum pancreatic enzyme levels in predicting pancreatic injuries has been a parameter of interest and the present recommendations on its utility are based primarily on anecdotal observations. The aim of this study was to evaluate the utility of serum pancreatic enzyme assessment in predicting blunt pancreatic injury with imaging and surgical correlation and compare our results with a systematic review of literature till date. A prospective cohort study conducted over 4 years in a tertiary care referral centre with 164 consecutive patients who presented to the emergency department with a history of blunt abdominal trauma and had serum pancreatic enzyme assessment, USG and subsequent diagnostic CECT were analyzed. The CT findings and AAST grade of pancreatic injury, various intra-abdominal injuries and time elapsed since injury and other associated factors were correlated with serum pancreatic enzyme levels. For systematic review of literature MEDLINE database was searched between 1940 and 2012, also the related citations and bibliographies of relevant articles were analyzed and 40 articles were included for review. We compared our results with the systematic critique of literature till date to formulate recommendations. 33(21%) patients had pancreatic injury documented on CT and were graded according to AAST. Statistically significant elevated serum amylase levels were observed in patients with pancreatic and bowel injuries. However, elevated serum lipase was observed specifically in patients with pancreatic injury with or without bowel injury. Combined serum amylase and lipase showed 100% specificity, 85% sensitivity in predicting pancreatic injury. Elevated (n=28, 85%) vs. normal (n=5, 15%) serum amylase and lipase levels showed sole statistically significant association with time elapse since injury to admission, with a cutoff of 3h. Based on our results and the systematic review of the literature till date we conclude, persistently elevated or rising combined estimation of serum amylase and lipase levels are reliable indicators of pancreatic injury and is time dependent, nondiagnostic within 6h or less after trauma. In resource constrained countries where CT is not available everywhere it may support a clinical suspicion of pancreatic injury and can be reliable and cost-effective as a screening tool.
    Injury 02/2014; · 2.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Chronic anal fissure is a benign disorder that is associated with considerable discomfort. Surgical treatment in the form of lateral sphincterotomy has long been regarded as the gold standard of treatment. This study compared the open and closed techniques of lateral sphincterotomy in terms of their postoperative outcomes. Methods A prospective, randomized comparative study was conducted between October 2010 and August 2012. A total of 136 patients were randomly assigned to each of two groups. Patients were followed up postoperatively for more than 1 year to assess any complications. The outcomes were compared among the two groups using the Chi-square test and Student t test. Results The mean age at presentation was 40.13 years. The male to female ratio was 1.47:1. The typical presentation was painful defecation. Fissures were most often located in the posterior midline and associated with a sentinel pile. Delayed postoperative healing was found in 4.4% of the group of patients undergoing open lateral sphincterotomy. The mean pain score and duration of hospital stay were lower with the closed technique. Conclusion Closed lateral internal sphincterotomy is the treatment of choice for chronic fissures as it is effective, safe, less expensive, and associated with a lower rate of complications than the open sphincterotomy technique.
    Asian Journal of Surgery. 01/2014;
  • Vikram Kumar, Gabriel Rodrigues, Chandni Ravi, Sampath Kumar
    [Show abstract] [Hide abstract]
    ABSTRACT: This prospective study was conducted at a tertiary care teaching hospital in South India over a period of 7 years and included 90 patients with incisional hernia (n = 90; 76 females and 14 males), operated over 2 years (January 2004 to December 2005), and followed-up for 5 years postoperatively (2005–2009). As per the surgical unit preference, patients underwent different methods of hernia repair—onlay mesh repair (n = 45, 50 %), underlay mesh repair (n = 18, 20 %), and anatomical repair (i.e., without mesh) (n = 27, 30 %). Parameters studied included seroma formation, wound infection, postoperative pain, and hernia recurrence. Although the first two parameters were statistically not significant, postoperative pain was found to be more in patients who underwent an underlay repair. A significant difference in the hernia recurrence rate was observed between mesh repair and anatomical repair groups. Hence, we conclude that all incisional hernias should be repaired with a mesh (meshplasty).
    Indian Journal of Surgery 08/2013; 75(4). · 0.09 Impact Factor
  • Gabriel Rodrigues, Raghunath Prabhu, Bharadwaj Ravi
    [Show abstract] [Hide abstract]
    ABSTRACT: Carcinoid tumours though commonly affect the appendix, are a rare cause of small bowel obstruction, causing a diagnostic dilemma. We presented a 70-year-old man with small bowel obstruction, not responding to conservative management, which required an emergency laparotomy and was found to have a mass encasing the mid-jejunal loops and mesentery that was resected and reported to be a carcinoid tumour.
    Case Reports 01/2013; 2013.
  • Source
    Chandni Ravi, Gabriel Rodrigues
    [Show abstract] [Hide abstract]
    ABSTRACT: Clinical examination is a simple method to detect breast lumps and their nature as it is inexpensive and non-invasive and if found to be accurate, might be of great value as a diagnostic tool. The aim of this study was to evaluate the accuracy of clinical examination and its contribution towards the diagnosis of a palpable breast lump. The study was record based and conducted at a University Medical College Hospital and a tertiary referral centre of South India. Patient files of those women who presented with a breast lump between January to December 2011 were studied. A total of 120 patients were obtained following necessary exclusions. The accuracy of clinical assessment at an outpatient facility was determined by comparing the physician's diagnosis with the final histopathological diagnosis. The inter-observer agreement (kappa) for diagnosing a breast lump was 81 % (95 % Confidence Interval = 71 % to 92 %) indicating a good agreement between clinical and pathological diagnoses. McNemar test also indicated a high degree of concordance between the two diagnoses (4.17 % discordance). Sensitivity, specificity, positive and negative predictive values of clinical breast examination in comparison to histopathology were 95, 88, 87, and 95 % respectively, with an overall accuracy of 90.8 %. 11 lumps were wrongly diagnosed at the time of clinical examination. Clinical examination of breast lumps was found to have a high sensitivity (94.5 %) and specificity (87.7 %) and can be used as the diagnostic tool to identify the nature of the lump, however, its value in diagnosing breast malignancy remains contributory due to the possibility that malignant lumps could be overlooked and present as advanced cancer at a later stage. Histopathology is recommended in all cases unless clinical examination is supported with strong evidence of benignity based on repeated breast imaging via ultrasound or mammogram (>35 yrs).
    Indian journal of surgical oncology. 06/2012; 3(2):154-7.
  • Source
    Lakshmi Rao, Vidya Monappa, Gabriel Rodrigues, B P Suresh
    [Show abstract] [Hide abstract]
    ABSTRACT: Extraosseous Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is an uncommon, aggressive, and malignant tumor with a poor patient outcome. Its occurrence in the lesser sac is a rare event and to the best of our knowledge, has not been previously described. The present case was clinically and radiologically misdiagnosed as a pancreatic tumor/gastrointestinal stromal tumor. Histopathology revealed a tumor with "small round cells" that were positive for CD99, confirming the diagnosis of ES/PNET. This report highlights the importance of considering Ewing's sarcoma in the differential diagnosis of intraabdominal, extraintestinal masses.
    The Korean Journal of Internal Medicine 03/2012; 27(1):91-4.
  • Digvijay Sarma, Raghunath Prabhu, Gabriel Rodrigues
    [Show abstract] [Hide abstract]
    ABSTRACT: Adult intussusception (AI) is a rare entity and differs from childhood intussusception in its presentation, etiology, and treatment. It accounts for 1/30,000 of all hospital admissions, 1/1300 of all abdominal operations, 1/30-1/100 of all cases operated for intestinal obstruction and one case of AI for every 20 childhood ones. This study was designed to review the mode of presentation, diagnosis and appropriate treatment and finally the etiology of cases presenting in our hospital over a period of 6 years. A retrospective review of 15 cases of intussusceptions in individuals older than 18 years presenting to a tertiary referral center of South India during a period of 6 years (2004-2010) was done in respect to mode of presentation, diagnosis, etiology and treatment. There were 15 cases of AI. Mean age was 45.5 years. Abdominal pain, nausea and vomiting were the commonest symptoms. There were 8 enteric, 6 ileocolic, and 1 colonic intussusceptions. 73% of AIs were associated with a definable lesion. Only 1 case of enteric lesions had malignancy. All ileocolic lesions were malignant. Twelve of 15 patients underwent surgical intervention. AI is a rare entity and requires a high index of suspicion. Small-bowel intussusception should be reduced before resection whenever possible if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant.
    Annals of Gastroenterology 01/2012; 25(2):128-132.
  • Source
    Gabriel Rodrigues
    Indian Journal of Surgery 12/2011; 73(6):439. · 0.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 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.
    Indian Journal of Surgery 08/2011; 73(4):256-61. · 0.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Stump appendicitis (SA) is a rare clinicopathologic entity characterised by inflammation of the appendiceal remnant after incomplete appendectomy. The diagnosis is not routinely suspected in patients who have previously undergone appendectomy. We report a case of SA in an adolescent boy who had previously undergone laparoscopic appendectomy. The case necessitated surgical completion of the appendectomy.
    Sultan Qaboos University medical journal 02/2011; 11(1):112-4.
  • Sunitha Carnelio, Sohil Ahmed Khan, Gabriel Rodrigues
    [Show abstract] [Hide abstract]
    ABSTRACT: Developments in dental pharmacotherapeutics require dentists to constantly update their knowledge of new drugs, drug safety, and therapeutic trends. Recent incidents of bisphosphonateassociated poor healing, spontaneous intraoral ulceration, and bone necrosis in the oral and maxillofacial region stress the need for vigilant spontaneous reporting of adverse events. This article discusses the rationale for pharmacovigilance in dental practice using specific methods and reviews the pros and cons of adverse drug reporting among dental practitioners.
    General dentistry 01/2011; 59(1):24-8; quiz 29-30, 80.
  • Source
    Gabriel Sunil Rodrigues, Sohil Ahmed Khan
    [Show abstract] [Hide abstract]
    ABSTRACT: To review the status of pharmacovigilance system among surgeons and in surgical wards with recommendations. Literature search using MEDLINE, cross-reference of published data and review of World Health Organization-Pharmacovigilance transcripts. Pharmacovigilance system is still in its infancy among surgeons and in surgical wards. No major studies have been published addressing this issue, till date. Surgeons are professionals least likely to report adverse drug reactions. Moreover widespread and irrational antibiotic use is contributing towards high incidence of adverse events apart from multidrug resistance. Lack of interest, funding and knowledge pose challenges in effective post marketing drug surveillance in surgery. A three tier proactive pharmacovigilance system in surgical wards is suggested along with specific recommendations. The pros and cons of adverse drug reporting among the surgeons are discussed. With growing awareness of pharmacovigilance in various fields of medicine, surgery can no longer remain an exception. In the transition from medical school to surgery clinic a subtle shift must occur from emphasizing pharmacokinetics to appreciating pharmacodynamics. This change in philosophy will occur at the level of instruction when the surgeons of tomorrow are motivated through regulatory and institutional means at school level to adopt pharmacovigilance in their clinical practices along with the practicing surgeons.
    Indian Journal of Surgery 01/2011; 73(1):4-8. · 0.09 Impact Factor
  • Source
    Sanjitha Sampathraju, Gabriel Rodrigues
    [Show abstract] [Hide abstract]
    ABSTRACT: Post mastectomy seroma remains an unresolved quandary as the risk factors for its formation have still not been identified. Seromas of the axillary space following breast surgery can lead to significant morbidity and delay in the initiation of adjuvant therapy. Various techniques and their modifications have been practiced and published in English literature, but there seems to be no consensus. In this article, all aspects of seroma formation from pathogenesis to prevention including drug therapies have been discussed.
    Indian journal of surgical oncology. 12/2010; 1(4):328-33.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Benign schwannomas arise from neural crest-derived Schwann cells. Schwannomas occurring in the biliary tract become clinically symptomatic due to their compression on the extra hepatic biliary tract causing obstructive jaundice. Their preoperative diagnosis is extremely difficult. We report a 38-year-old male who presented with pain abdomen and jaundice. Computed tomography of abdomen showed extra luminal compression of common bile duct (CBD) possibly by a lymph nodal mass. Resection of the CBD, gall bladder and the mass compressing the CBD with Rouxen-Y hepaticojejunostomy was performed. The final histopathology was reported as a schwannoma.
    Indian Journal of Surgery 07/2010; 72(Suppl 1):333-5. · 0.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts is a low grade, rare, soft tissue tumor which commonly occurs on the lower extremities of adults of either sex, though lesions in other anatomic locations have been described. We present a case of a 65-year-old female patient who presented with a left forearm swelling and underwent a wide local excision. Histopathology revealed it to be a PHAT.
    Indian Journal of Surgery 06/2010; 72(3):263-4. · 0.09 Impact Factor
  • Source
    Indian Journal of Surgery 04/2010; 72(2):165-6. · 0.09 Impact Factor
  • Source
    Gabriel Sunil Rodrigues, Dileep Namvar Lobo
    Indian Journal of Surgery 02/2010; 72(1):74. · 0.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Though gastrointestinal stromal tumours are common, a duodenal stromal tumour is a rare entity. We present such a rare case with duodenal obstruction which caused a dilemma in the management of this patient. Though a Whipple’s operation was planned, intraoperatively, due to the pedunculated nature and free intraluminal mobility, resection of the polyp was done and histopathology was consistent with the diagnosis of a duodenal stromal tumour, which was reconfirmed with special stains/immunohistochemistry. Surgeons and pathologists should keep this rare primary tumour of the duodenum in mind as a differential diagnosis when examining/treating duodenal lesions, as a major surgical intervention can be avoided, cutting down on the cost, hospital stay, morbidity and mortality to the patient. A literature review and a discussion on the pertinent clinical, radiological, pathological and surgical aspects of stromal tumours have been discussed.
    01/2010;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Preoperative starvation has many undesirable effects but the minimum length of fasting is limited by gastric emptying, which may be dependent on nutrient content, viscosity and osmolarity of the feed. We compared the gastric emptying of two types of preoperative metabolic preconditioning drinks [Oral Nutritional Supplement (ONS) (Fresenius Kabi, Germany) and preOp (Nutricia Clinical Care, UK)] in healthy volunteers. Twenty (10 male, 10 female) healthy adult volunteers were studied on 3 separate occasions in a randomised crossover manner. Volunteers ingested 400 ml preOp, which is a clear carbohydrate drink (CCD) (50 g carbohydrate, 0 g protein), 70 g ONS (50 g carbohydrate and 15 g glutamine) dissolved in water to a total volume of 400 ml (ONS400) and 300 ml (ONS300). Gastric emptying time was measured using magnetic resonance imaging. Mean (95% CI) T(50) and T(100) gastric emptying times for CCD were significantly lower (p<0.001) compared with ONS400 and ONS300. T(50) was 47 (39-55), 78 (69-87) and 81 (70-92)min for CCD, ONS400 and ONS300 respectively. Correspondingly T(100) was 94 (79-110), 156 (138-173) and 162 (140-184)min. Residual gastric volumes returned to baseline 120 min after CCD and 180 min after ONS400 and ONS300. The faster gastric emptying for CCD compared to ONS400 and ONS300 signifies that gastric emptying may be more dependent on nutrient load than volume or viscosity in healthy volunteers. While it is safe to give CCD 2h preoperatively, ONS400 and ONS300 should be given at least 3h preoperatively.
    Clinical nutrition (Edinburgh, Scotland) 06/2009; 28(6):636-41. · 3.27 Impact Factor
  • Source
    Indian Journal of Surgery 10/2008; 70(5):252-3. · 0.09 Impact Factor