Browsing by Author "Kanika Sharma"

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Advancing Precision in Penile Length Measurement: Evidence-based Synthesis of Stretched Penile Length INdicator Technique (SPLINT)
(Wolters Kluwer Medknow Publications, 2024) Prabudh Goel; Prativa Choudhury; Komal Kaur Saroya; Vishesh Jain; Anjan Kumar Dhua; Devendra Kumar Yadav; Sachit Anand; Sandeep Agarwala; Kanika Sharma; Vikesh Agrawal; Subhasis Saha; Harpreet Singh; Naveen Sharma; V.P. Singh
Purpose: The purpose of this study was to synthesize evidence and propose a technique for estimation of stretched penile length (SPL) applicable to children. Materials and Methods: This review has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Embase, and Scopus databases were queried on penile length (PL) measurement techniques in humans published from 1990 onward. The devices and the techniques used for PL measurement, state of the penis, the habitus of the participants, proximal and distal landmarks for measurement, handling the foreskin and pubic pad of fat, optimal stretching of the penis, and other factors (including the environment) which should be accounted for in the technique were identified from the study cohort (90895 participants across 145 included studies). Results: PL has been represented through flaccid (33.79%), stretched (81.3%), and erect (12.41%) PLs as well as the greatest corporeal length (1.4%). Following devices have been used to measure the PL in the study cohort: rulers [54.68%], calipers [9.7%], measuring tapes [14.5%], coloured measuring strips [2.06%], spatulas/tongue depressors [11.03%], FitKit, syringe [1.4%], cotton swab (and ruler), titan cylinders, slide gauge and ultrasonography [1.37%]. The factors relevant to SPL measurement have been incorporated into the proposed SPL INdicator Technique (SPLINT) which is essentially a holistic extension of the "Conventional PL Measurement"technique. Conclusions: There is a wide range of heterogeneity in the technique for estimation of PL across the study cohort; the underlying factors have been identified along with the respective variables, and the SPLINT for SPL has been described. © 2024 Journal of Indian Association of Pediatric Surgeons.
Giant bilateral pediatric thymolipoma presenting with respiratory distress
(Elsevier Inc., 2021) Kanika Sharma; Shilpa Sharma; Rachna Seth; Devendra K. Gupta
Thymolipoma is a rare thymic mass usually incidentally diagnosed. We present the case of an 8-year old child who presented with breathlessness and cough. On evaluation, she had a giant anterior mediastinal mass involving bilateral hemithorax (right > left) which was diagnosed as thymolipoma. The child was started on steroids, to which she responded very well initially, but after few months the thymic mass gradually increased again and respiratory distress reccured. Subsequently total excision of mass was done followed by gradually tapering of steroids. The child had excellent recovery and is asymptomatic at 2.5 years follow up. © 2021 The Authors
Inverted-Y Ureteric Duplication With Paraureteric Diverticulum Presenting With Bladder Outlet Obstruction in an Infant- A Diagnostic Dilemma
(Elsevier Inc., 2023) Sunil Kumar Singh Gaur; Maharani Adhikari; Akash Mishra; Deepak Kumar; Amrita Ghosh Kar; Shivi Jain; Sarita Chawdhary; Kanika Sharma
The ectopic ureter and paraureteric diverticulum are 2 known common urological anomalies of pediatric patients. Another rare entity is inverted-Y ureteric duplication. We report a case of a 3-month-old boy presented with bladder outlet obstruction, where surgical excision of large bladder diverticulum with left ureter and small kidney was done. Histopathology confirmed the presence of inverted-Y ureteric duplication with left dysplastic kidney. The report defines the first case of infantile bladder outlet obstruction having the co-existing congenital genitourinary anomaly of inverted Y-partial ureteric duplication with obstructive ectopic ureter and ipsilateral paraureteric diverticula. © 2022 Elsevier Inc.
Measuring up: Ensuring Intra‑ and Interobserver Reliability in Stretched Penile Length with the SPLINT Technique
(Wolters Kluwer Medknow Publications, 2024) Prabudh Goel; Prativa Choudhury; Vivek Verma; Shivani Phugat; Mani Kalaivani; Teg Rabab Singh; Kanika Sharma; Vishesh Jain; Devendra Kumar Yadav; Anjan Kumar Dhua; Sandeep Agarwala
Background: A discrepancy between the true and measured value of stretched penile length (SPL) may be a result of errors that can either be systematic or random. Hence, it becomes important to focus on the quality of measurements to prevent any iatrogenic harm to the patients. Objective: The objective of this study was to assess the magnitude of intra‑ and interobserver variations in the measurement of SPL with the SPLINT technique. Materials and Methods: SPL was measured prospectively in a cohort of 449 boys aged 0–14 years including 68 infants (substratified into Group I: >4 years, Group II: 4–8 years, and Group III: >8 years) with the SPLINT technique by expert (E: E1 and E2) and trainee (T: T1 and T2) surgeons after completing a three‑tiered training module. Intra‑ and interobserver variability was assessed through descriptive statistics, intraclass correlation (ICC), relative technical error of measurement (rTEM), and reliability or R (%). Results: Intraobserver variability: the mean difference between the two readings (E1 and E2) is 0.08 cm (95% confidence interval [CI]: 0.073–0.087), ICC was 0.998 (95% CI: 0.997–0.998), and intraobserver variability ≤0.1 cm in 85% of the participants (n = 370 of 433). The rTEM and reliability (%) were 1.82% and 98.1% (Group I), 1.65% and 98.9% (Group II), and 1.09% and 99.7% (Group III), respectively. The intraobserver variability was observed to be inversely proportional to the age of the participants (correlation coefficient = −0.56). Interobserver variability was calculated separately for expert versus trainee and trainee versus trainee (T‑vs‑T) measurements. For expert versus expert, ICC, rTEM, and reliability (%) were 0.984, 2.4%, and 96.8% (Group 1), 0.992, 2.07%, and 98.3% (Group 2), and 0.997, 1.38%, and 99.05% (Group 3), respectively. A similar pattern of variability was observed for T‑vs‑T measurements. The reliability (%) of the SPL by experts is consistently more than that of trainees across all age groups; however, the difference ameliorates with the age of participant. Conclusions: The study has validated the SPLINT technique by demonstrating a high level of intra‑ and interobserver reliability. The adequacy of the training modules for SPL measurements described in this study has also been established. Evidence that the SPL can be used as an objective marker of penile dimensions is herewith furnished. © 2024 Journal of Indian Association of Pediatric Surgeons.
Ovotesticular Disorder of Sex Development in a Tertiary Care Center in North India: A Single‑center Analysis over a 5‑year Period
(Wolters Kluwer Medknow Publications, 2023) Sarita Chowdhary; Maneesha Upadhayaya; Gunjan Rai; Manpreet Kaur; Nitish Kumar Singh; Kanika Sharma; Ritesh Yadav; Bitan Naik; Shiv Prasad Sharma; Royana Singh
Background: Disorders of sexual development (DSD) encompass a group of congenital conditions characterized by diverse genotypic and phenotypic variations. Ovotesticular (OT) DSD is a distinctive subtype within this spectrum. Among the array of DSD, OT-DSD stands as one of the most infrequent anomalies, with reported prevalence rates as scarce as 1 in 83,000. This study aims to elucidate the clinical, hormonal, cytogenetic, surgical, and histopathological characteristics of OT disorder of sex development (OT-DSD) within a tertiary center in North India. Methodology: A retrospective analysis was conducted, involving a comprehensive review of records pertaining to OT-DSD patients from the years 2018 to 2022, all of whom were incorporated into the study. Results: The mean age of presentation in this study was 10 years, spanning from 6 to 15 years. Predominantly, the affected individuals were male, with a solitary patient representing the female category. Clinical manifestations displayed a spectrum encompassing genital ambiguity, inguinal swelling, and primary amenorrhea. The karyotypes observed were 46,XX in four patients and 46,XY in one patient. A holistic assessment, inclusive of clinical evaluation, hormonal assays, pelvic ultrasonography, and surgical intervention when necessary, was administered to all patients. Among these cases, three patients were reared as males, their gender assignment driven by external genital appearance and sociocultural influences. Notably, none of the patients manifested gonadal tumors during the course of the study. Conclusion: In cases of ambiguous genitalia, the consideration of OT-DSD should be integral to the differential diagnosis, underscoring the significance of heightened clinical awareness and informed decision-making. © 2023 National Journal of Clinical Anatomy | Published by Wolters Kluwer - Medknow.
Role of Diffusion Weighted MRI (DW-MR) in Detection of Satellite Lesions Not Detected with Multiphase CT Scans in Hepatoblastoma and Its Implications for Management
(Springer, 2022) Kanika Sharma; Sandeep Agarwala; Devasenathipathy Kandasamy; Manisha Jana; Raju Sharma; Anjan Dhua; Vishesh Jain; Veereshwar Bhatnagar
Objective: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MR) in hepatoblastoma as compared to multiphase contrast enhanced computed tomography (CECT) scans for detection of satellite lesions. Methods: In this prospective study on new cases of hepatoblastoma, multiphase CECT scans and DW-MR were performed before initiation of chemotherapy. Results of interpretation were compared for detection of satellite lesions. PRETEXT grouping and risk categorization was done according to SIOPEL based on CECT scan. Results: Nine boys and 1 girl with hepatoblastoma, with median age of 11.5 mo were included. All patients were stratified as high-risk group with 2 (20%) in PRETEXT II and 8 (80%) in PRETEXT III. In 2 of 10 (20%) patients, additional satellite lesions were detected on DW-MR, which upgraded their stage. One of the two patients had one satellite lesion identified on CECT, while additional seven satellite lesions were identified on DW-MR imaging. For the other patient, CECT showed no satellite lesion while DW-MR detected six satellite lesions. Conclusion: MRI has become the gold standard investigation for evaluation of hepatoblastoma. DW-MR, which is a contrast free technique, is a better tool for assessment of satellite lesions which are usually missed on CECT. This would help in proper staging, planning of management and prognostication. © 2021, Dr. K C Chaudhuri Foundation.
Screening of insecticidal activity of Origanum majorana oil against Tribolium castenium
(2009) Naveen Sharma; N.K. Dubey; Kanika Sharma
Origanum majorana essential oil was tested for its potency as botanical pesticide to protect stored food commodities from insect infestation. The oil was found to be an effective repellent against the beetle Tribolium castenium (L.). An inverse relationship was observed with between concentration of oil and oviposition. Treatment of 1000 and 500 ppm found maximum mortality while 5 ppm concentration can be considered good against oviposition of insect T. castenium.
To determine the genotyping of Fc-gamma receptor FCGR2A polymorphism as genetic susceptibility to neonatal sepsis: A study from a tertiary center of North India
(Wolters Kluwer Medknow Publications, 2022) Sarita Chowdhary; Kanika Sharma; Ashish Ashish; Abhay Kumar Yadav; Pranay Panigrahi; Akas Mishra; Deepak Kumar; Royana Singh
Background: Neonatal sepsis term is an infection of newborns <28 days of age. It is a common cause of death in developing countries. The receptor-gamma receptor FCGR2A has been shown to be associated with neonatal sepsis. It is an activating receptor found in many cell types such as monocytes, neutrophils, macrophages, platelets, and others. The receptor has a polymorphism (single-nucleotide polymorphism rs1801274) in its gene (FCGR2A) that encodes either a histidine (H) or arginine (R) at amino acid position 131. There are many studies showing the impact of these FCGR2A polymorphisms on sepsis. Our study aims to determine the prevalence of Fc-gamma receptor FCGR2A (rs1801274) polymorphism in neonatal sepsis and control in Eastern UP populations. Patients and Methods: We conducted a cross-sectional descriptive study of 590 patients (310 healthy individuals and 280 sepsis patients) to determine polymorphisms in the CD32A coding region in neonates. All individuals were genotyped for a variant at position 131 of the FcγRIIA gene. Discussion: In our study, the prevalence of FcγRIIa polymorphism is more in neonates with sepsis than in noninfected neonates. It was observed that the heterozygous allele (AG) were significantly increased in septic neonates when compared to the normal. Conclusion: Our data indicate that FcγRIIA genotyping can be used as a marker of genetic susceptibility to sepsis. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Varied parameters and utility of the anal position index: a systematic review and meta-analysis
(Springer Science and Business Media Deutschland GmbH, 2021) Shilpa Sharma; Vanamail Perumal; Kanika Sharma; Devendra K. Gupta
Purpose: The anal position index (API) was described in 1984 by Reisner et al. Since then, it has been measured in different ethnic populations and its utility in various medical conditions have been explored. We aimed to review the literature regarding the various values reported analytically. Method: A Pubmed Search was carried out with the terms Anal Position Index. There were 158 articles hit by the search. The description of the API was uniform in all studies, described as ratio of anus–fourchette distance in girls and anus–scrotum distance in boys to the distance between coccyx and fourchette/scrotum. 18 relevant studies were included describing the values in different ethnic groups and describing its utility. One study was excluded from statistics due to different landmark for measurement. The studies were grouped into 4. Group A:B:C:D comprised of Newborns:Infants:All age groups:Constipated children. We carried out meta-analysis to estimate effect size (mean difference) using STATA software version 16.0. Results: The different ethnic populations in which API were measured, and were Indian (2), Turkish (3), Israel (2), Taiwanese, Thai, Iranian, Spanish, Italian, and Mexican. The API was higher by 0.129 in boys. The mean API in males was 0.53:0.54:0.48:0.52 in Group A:B:C:D with an overall mean (SD) API of 0.51 (0.04). The mean API in females was 0.40:0.40:0.38:0.37 in Group A:B:C:D with an overall mean (SD) API of 0.40(0.03). Two studies were done in mice and showed the relation of API to intrauterine exposure to androgens. In children, API was mostly used to diagnose an anterior ectopic anus and see correlation with constipation. The abnormal values varied from less than 0.30–0.34 in girls and less than 0.41–0.46 in boys. The effect size by regions showed that the estimated effect size for all the regions were within 95% Confidence limits of overall estimate (0.13: 95% CI: 0.13–0.14). Therefore, it can be inferred that there was no significant ethnic variation in the study parameter. The anal position in relation to genitalia was measured in nulliparous women, menopause women, and women with levator deficiency. It was affected in vulvovaginal atrophy. Dichlorodiphenyldichloroethylene exposure during the first trimester of pregnancy was reported to alter the anal position in male infants. Conclusion: The anteriorly positioned anus has been associated with constipation. API been measured in various ethnic populations with insignificant variations. The API is significantly (p < 0.05) higher in males. The presence of constipation does not seem to alter API. One should adopt a single method for measurement. API should not be considered at the sole indication for any surgical intervention. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.