Browsing by Author "Sameer Trivedi"

Now showing 1 - 20 of 74

A comparative study of artificial neural network and multivariate regression analysis to analyze optimum renal stone fragmentation by extracorporeal shock wave lithotripsy.
(2010) Neeraj K Goyal; Abhay Kumar; Sameer Trivedi; Udai S Dwivedi; T.N. Singh; Pratap B Singh
To compare the accuracy of artificial neural network (ANN) analysis and multi-variate regression analysis (MVRA) for renal stone fragmentation by extracorporeal shock wave lithotripsy (ESWL). A total of 276 patients with renal calculus were treated by ESWL during December 2001 to December 2006. Of them, the data of 196 patients were used for training the ANN. The predictability of trained ANN was tested on 80 subsequent patients. The input data include age of patient, stone size, stone burden, number of sittings and urinary pH. The output values (predicted values) were number of shocks and shock power. Of these 80 patients, the input was analyzed and output was also calculated by MVRA. The output values (predicted values) from both the methods were compared and the results were drawn. The predicted and observed values of shock power and number of shocks were compared using 1:1 slope line. The results were calculated as coefficient of correlation (COC) (r2 ). For prediction of power, the MVRA COC was 0.0195 and ANN COC was 0.8343. For prediction of number of shocks, the MVRA COC was 0.5726 and ANN COC was 0.9329. In conclusion, ANN gives better COC than MVRA, hence could be a better tool to analyze the optimum renal stone fragmentation by ESWL.
A Comparison Between Intravesical Gemcitabine Plus Docetaxel and Intravesical Bacillus Calmette-Guérin in the Treatment of Nonmuscle Invasive Naive Urinary Bladder Cancer: A Systematic Review and Meta-analysis of Oncological Outcomes
(2025) Rachana Tripathy; Lalit Kumar; Sakshi Agarwal; Anuja Thakur; Mahesh R. Khairnar; Sameer Trivedi; Satya Narayan Sankhwar
This study evaluated the efficacy, recurrence rates, and safety of intravesical gemcitabine plus docetaxel compared to standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), with a focus on reducing recurrence and progression concerns associated with transurethral resection (TURBT). A systematic review and meta-analysis of three original studies were conducted, assessing recurrence rates and safety profiles. The meta-analysis revealed no heterogeneity in recurrence rates between the gemcitabine plus docetaxel and BCG groups, with an overall Odds Ratio for recurrence of 0.72 (95% CI: 0.36-1.47). Although the clinical recurrence rate was slightly lower in the gemcitabine plus docetaxel group, the difference was not statistically significant (Z = 0.89, P = 0.37). The gemcitabine plus docetaxel group experienced fewer severe side effects compared to the BCG group. Due to the limited number of studies available, further randomized trials are necessary to confirm the role of intravesical gemcitabine plus docetaxel in NMIBC management. © © 2025 Elsevier Inc. All rights reserved.
A Comparison Between Intravesical Gemcitabine Plus Docetaxel and Intravesical Bacillus Calmette-Guérin in the Treatment of Nonmuscle Invasive Naive Urinary Bladder Cancer: A Systematic Review and Meta-analysis of Oncological Outcomes
(Elsevier Inc., 2025) Rachana Tripathy; Lalit Kumar; Sakshi Agarwal; Anuja Thakur; Mahesh R. Khairnar; Sameer Trivedi; Satya Narayan Sankhwar
This study evaluated the efficacy, recurrence rates, and safety of intravesical gemcitabine plus docetaxel compared to standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), with a focus on reducing recurrence and progression concerns associated with transurethral resection (TURBT). A systematic review and meta-analysis of three original studies were conducted, assessing recurrence rates and safety profiles. The meta-analysis revealed no heterogeneity in recurrence rates between the gemcitabine plus docetaxel and BCG groups, with an overall Odds Ratio for recurrence of 0.72 (95% CI: 0.36–1.47). Although the clinical recurrence rate was slightly lower in the gemcitabine plus docetaxel group, the difference was not statistically significant (Z = 0.89, P = 0.37). The gemcitabine plus docetaxel group experienced fewer severe side effects compared to the BCG group. Due to the limited number of studies available, further randomized trials are necessary to confirm the role of intravesical gemcitabine plus docetaxel in NMIBC management. © 2025 Elsevier Inc.
A cost-effective modified split graft technique using bovine pericardium after plaque excision in Peyronie's disease - An initial experience
(Wolters Kluwer Medknow Publications, 2025) Lalit Kumar; Anil Baliyan; Aviral Srivastava; Anuja Thakur; Sameer Trivedi
Aims: The plaque excision and grating technique is indicated for correcting penile curvature in Peyronie's disease. We assessed our experience of the modified split graft technique using bovine pericardium after plaque excision. Materials and Methods: Between March 2020 and September 2024, we operated on 12 patients by the excision of plaque and split grafting technique. Here, we discuss our experience customizing a bovine pericardium graft on a table according to the size of the defect and joining pieces of graft and tunica albuginea with a Polydioxanone (PDS) suture to cover the cavernosal defect. Results: Patients' mean age and follow-up were 48 years and 30 months, respectively. The average size of the plaque and penile curvature was 4.6 cm (range 1.5-8 cm) and 45°, respectively. No residual penile curvature was observed in 83.5% of patients while (16.5%) had curvature of <20°. All patients experienced an improvement in stretched penile length with an average increase of 1.6 cm. Seventy-five percent of patients were able to perform sexual activity without assistance after 3 months. One patient, who had a sizeable cavernosal defect of 8 cm × 2 cm, experienced severe postoperative erectile dysfunction (ED) along with residual penile curvature of 15° and required semi-rigid penile prosthesis. Two patients having mild ED was managed by Tadalafil 10 mg. Another patient with residual chordee of <20° was managed on conservative therapy. Conclusions: In our limited experience, this modified split graft technique using bovine pericardium after plaque excision seems feasible, cost-effective, and safe. It has comparable outcomes to the standard methods reported in the literature and reduces graft material wastage. Further, long-term randomized trials are needed to validate its long-term efficacy and safety compared to conventional grafting approaches. © 2025 Urology Annals.
Array-based DNA methylation profiling reveals peripheral blood differential methylation in male infertility
(Elsevier Inc., 2019) Saumya Sarkar; Kumar Mohanty Sujit; Vertika Singh; Rajesh Pandey; Sameer Trivedi; Kiran Singh; Gopal Gupta; Singh Rajender
Objective: To study peripheral blood DNA differential methylation in oligozoospermic infertile men in comparison with normozoospermic fertile controls. Design: Case-control study. Setting: Reproductive biology laboratory. Patients(s): Azoospermic and oligozoospermic infertile patients (n = 6) and normozoospermic fertile controls (n = 6) in the discovery phase, and oligo/asthenozoospermic infertile men (n = 11) and normozoospermic fertile controls (n = 10) in the validation phase. Intervention(s): Blood samples drawn from all participants, DNA isolation and methylation analysis. Main Outcome Measure(s): DNA methylation values analyzed using genomewide methylation 450K BeadChip array, followed by deep sequencing of selected regions for methylation analysis in the neighborhood regions of differentially methylated CpGs. Result(s): We found 329 differentially methylated CpG spots, out of which 245 referred to the genes, representing 170 genes. Deep-sequencing analysis confirmed the methylation pattern suggested by 450K array. A thorough literature search suggested that 38 genes play roles in spermatogenesis (PDHA2, PARP12, FHIT, RPTOR, GSTM1, GSTM5, MAGI2, BCAN, DDB2, KDM4C, AGPAT3, CAMTA1, CCR6, CUX1, DNAH17, ELMO1, FNDC3B, GNRHR, HDAC4, IRS2, LIF, SMAD3, SOD3, TALDO1, TRIM27, GAA, PAX8, RNF39, HLA-C, HLA-DRB6), are testis enriched (NFATC1, NMNAT3, PIAS2, SRPK2, WDR36, WWP2), or show methylation differences between infertile cases and controls (PTPRN2, RPH3AL). Conclusion(s): We found a statistically significant correlation between peripheral blood DNA methylation and male infertility, raising the hope that epigenome-based blood markers can be used for screening male infertility risk. The study also identified new candidates for spermatogenesis and fertility. © 2019 American Society for Reproductive Medicine
Assessing the clinical efficacy of neoadjuvant intravesical Mitomycin C in naïve non-muscle invasive urinary bladder cancer: A systematic review and meta-analysis
(Elsevier Inc., 2025) Anuja Thakur; Lalit Kumar; Sakshi Agarwal; Rachana Tripathy; Yashasvi Singh; Sameer Trivedi; Ujwal Kumar
Background and Objective: Naïve non-muscle invasive bladder cancer (NMIBC) is commonly treated with transurethral resection (TURBT), but recurrence and progression remain concerns. This meta-analysis, the first we have conducted on this topic, compared recurrence and progression rates between patients treated with neoadjuvant Mitomycin C (MMC) and the control group (TURBT alone). Methods: Relevant articles were identified and appraised through a structured literature assessment. Databases searched included PubMed, Medline, Scopus, and Science Direct. Duplicate publications, book sections, conference papers, encyclopedias, case reports, magazine articles, presentations, theses, protocols, systematic reviews, and meta-analyses were excluded. Heterogeneity was assessed using the I2. Key findings and limitations: The meta-analysis evaluated recurrence rates, progression rates, and adverse events. No heterogeneity was observed (I2=0 %). The pooled odd ratio (OR) for recurrence was 2.554 (95 % CI: 1.637-3.986), indicating a significant decrease in recurrence for the MMC group (P < 0.001). For progression rates, the overall pooled OR was 1.508 (95 % CI: 0.832-2.734), suggesting that the MMC group showed a lower progression rate. However, this difference was not statistically significant (P = 0.176).Adverse events varied, with the MMC group showing fewer cases of hematuria (8.4 % vs. 34 %) but more irritative bladder symptoms. Conclusions and Clinical Implications: The meta-analysis suggests lower recurrence and progression rates in the neoadjuvant MMC group compared to the control group. Both groups experienced a comparable range of adverse events, suggesting that both treatment approaches exhibit a similar safety profile. Larger and more randomized controlled trials (RCT) are needed to confirm MMC's effectiveness in NIMBC treatment and establish its role in clinical practice. © 2025 Elsevier Inc.
Association of interleukin-1beta C + 3953T gene polymorphism with human male infertility
(2013) Deepika Jaiswal; Sameer Trivedi; Neeraj K. Agrawal; Rajendra Singh; Kiran Singh
Cytokines are involved in the regulation of spermatogenesis likely mediating the crosstalk among Sertoli and germ cells to facilitate germ cell movement across the seminiferous epithelium during cellular events such as germ cell differentiation. Members of the Interleukin-1 (IL-1) family are pleiotropic cytokines that are involved in inflammation, immunoregulation, and other homeostatic functions. Interleukin-1 alpha (IL-1α), IL-1β, and the IL-1 antagonistic molecule (IL-1 Ra) are present in the testis under normal homeostasis and they further increase upon infection/inflammation. In the present study we have examined the association of C + 3953T polymorphism of the human IL-1B gene with human male infertility. The case control study comprised of two groups: 222 infertile patients and 230 fertile healthy control men. Genotyping for SNP C + 3953T IL-1B was carried out by polymerase chain reaction followed by analysis with specific endonucleases (PCR-RFLP). DNA sequencing was used to validate the PCR-RFLP results. The genotype frequencies of the IL-1B Taq C/T polymorphism were compared between infertile men and controls. The frequency was significantly higher in asthenozoospermic patients compared to fertile control men (odds ratio = 10.4, CI: 2.50- 43.96, p = 0.001). The C + 3953T of the IL-1B gene is associated with male infertility risk in the asthenozoospermic patients from an Indian population. © 2013 Informa Healthcare USA, Inc.
Association of polymorphism in cell death pathway gene FASLG with human male infertility
(Elsevier (Singapore) Pte Ltd, 2015) Deepika Jaiswal; Sameer Trivedi; Neeraj K Agrawal
Objective: To investigate -844C>T single nucleotide polymorphism (SNP) present in the promoter of cell death pathway gene FASLG with male infertile phenotype. Methods: Genotyping for SNP FASLG (rs763110) was done by polymerase chain reaction followed by analysis with specific endonuclease (PCR-RFLP). DNA sequencing was used to ascertain PCR-RFLP results. Results: FASLG -844C>T polymorphism, allele and genotype distribution did not differ significantly between patients and controls (OR: 1.03, 95% CI= 0.7638 to 1.3952, P=0.83). Thus SNP-844C>T of the FASLG gene is not associated with male infertility risk in the analyzed patients. Conclusions: Human male infertility is a complex disorder and thus other genetic or environmental factors may be contributing to the complex etiology, and further study in other region of Indian populations will verify whether it is associated with male infertility risk. © 2015 Hainan Medical College.
Association of the IL1RN Gene VNTR Polymorphism with Human Male Infertility
(2012) Deepika Jaiswal; Sameer Trivedi; Rajendra Singh; Rima Dada; Kiran Singh
Interleukin-1 (IL-1) is a regulatory cytokine that plays an important role in the maintenance of the immune environment of the testis, regulation of junction dynamics and cell differentiation during spermatogenesis. Members of the IL-1 family are pleiotropic cytokines that are involved in inflammation, immunoregulation and other homeostatic functions in the body. IL-1α, IL-1β, and the IL-1 receptor antagonistic molecule (IL-1 Ra) are expressed in the testis under normal homeostasis and they further increase upon infection/inflammation. In the present study we have examined the association of Variable Number Tandem Repeats (VNTR) polymorphism of the Interleukin-1 receptor antagonist gene (IL1RN) with human male infertility. The case-control study comprised of two groups: 331 idiopathic infertile patients and 358 fertile healthy men. The study indicates risk of IL1RN2 variant with male infertility (OR: 1.43, CI: 1.1546 to 1.7804, P = 0.001). To our best knowledge, this is the first report that links IL1RN VNTR polymorphism with human male infertility. © 2012 Jaiswal et al.
Association of the patterns of global DNA methylation and expression analysis of DNA methyltransferases in impaired spermatogenic patients
(Elsevier (Singapore) Pte Ltd, 2015) Deepika Jaiswal; Sameer Trivedi; Neeraj K. Agrawal; Kiran Singh
Objective: To analyze global DNA methylation along with DNA methyltransferases (DNMTs) expression at transcript level in patients with impaired spermatogenesis to dissect its role in pathophysiology of human male infertility. Method: The content of Global methylated cytosine (mC) was determined using ELISA system (Imprint Methylated DNA Quantification Kit, Sigma-Aldrich) in 31 testicular biopsies showing impaired spermatogenesis and 8 with normal spermatogenesis. Real-time reverse transcription-polymerase chain reaction was done to analyze DNMTs (DNMT1, DNMT3A, DNMT3B and DNMT3L) mRNA levels in biopsies with different testicular phenotypes. Results: There was significant increase in levels of global methylation in different impaired testicular phenotypes as compared to normal. Expression analysis revealed significantly increased expression of DNMT1 and its positive correlation with global DNA methylation. Conclusion: In conclusion, increased levels of global methylation in impaired cases might be the one of the contributing factors for aberrant gene expression in infertile patients. © 2015 The Authors.
AZF deletions in Indian populations: original study and meta-analyses
(Springer, 2020) Andrabi Syed Waseem; Vertika Singh; Girish Chandra Makker; Sameer Trivedi; Geetanjali Mishra; Kiran Singh; Singh Rajender
Purpose: To identify the frequency of Y chromosome microdeletions in Indian populations and to quantitatively estimate the significance of association between these deletions and male infertility. Methods: A total of 379 infertile males (302 azoospermic and 77 oligozoospermic infertile males) and 265 normozoospermic fertile males were evaluated for Y chromosome microdeletions (YCD) using PCR amplification and gel electrophoresis. Meta-analyses were performed on AZFa (2079 cases and 1217 controls), AZFb (2212 cases and 1267 controls), AZFc (4131 cases and 2008 controls), and AZFb+c (1573 cases and 942 controls) deletions data to quantitatively estimate the significance of association between these deletions and male infertility in Indian populations. Results: The results revealed that out of 379 infertile azoospermic and oligozoospermic males, 38 (10.02%) had AZF deletions. No deletion was found in control samples. The highest percentage of deletions was observed in the AZFc region, followed by AZFa and AZFb. Qualitative analysis showed that AZF deletions were present in 0.59 to 32.62% (average 13.48%) of infertile cases in Indian populations. Meta-analysis revealed a significant association of AZFa (OR = 6.74, p value = 0.001), AZFb (OR = 4.694, p value = 0.004), AZFc (OR = 13.575, p value = 0.000), and AZFb+c (OR = 5.946, p value = 0.018) deletions with male infertility. Conclusion: AZF deletions were seen in 10.02% of azoospermic and oligozoospermic cases with the highest frequency of AZFc deletions. Pooled analysis for all studies showed deletion frequency from 0.59 to 32.62% (average = 13.48%). Meta-analysis showed significant association of AZFa, AZFb, and AZFb+c deletions with male infertility. Analysis of Y chromosome microdeletions should be reckoned as an essential testing for diagnostic and therapeutic purposes. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Azoospermic infertility is associated with altered expression of DNA repair genes
(Elsevier B.V., 2019) Vertika Singh; Deepika Jaiswal; Kanhaiya Singh; Sameer Trivedi; Neeraj K Agrawal; Gopal Gupta; Singh Rajender; Kiran Singh
Compelling evidence suggest that germs cells are predominantly sensitive to DNA damaging agents in comparison to other cells. High fidelity DNA repair in testicular cells thus becomes indispensable to preserve the genomic integrity for passing on to the progeny. Compromised DNA repair machinery in the testicular cells may result in impaired spermatogenesis and infertility. It remains unclear if the alterations in the expression of DNA repair genes correlate with azoospermia and male infertility. In the present study, 54 non-obstructive azoospermic infertile patients with hypospermatogenesis (HS, n = 26), maturation arrest (MA, n = 15), Sertoli cell only syndrome (SCOS, n = 13) and 14 controls with obstructive azoospermia, but normal spermatogenesis were recruited. Expression profiling of 84 DNA repair genes in testicular biopsy samples was performed using PCR array. Out of 84 genes, 27, 64 and 28 genes showed >5 fold down-regulation in the HS, MA and SCOS groups, respectively. On the basis of differential expression and their functional significance in spermatogenesis, ten genes (MSH2, BRIP1, CCNH, LIG4, MGMT, NTHL1, PMS1, DMC1, POLB and XPA) were selected for validation of transcript levels in a higher number of cases using RT-PCR, which corroborated the findings of array. Four genes (MSH2, LIG4, PMS1 and DMC1) were analyzed for protein levels using immunohistochemistry, which further validated the loss of DNA repair gene expression. Caspase-3 immunostaining showed that the loss of DNA repair correlated with increased testicular apoptosis in patients. Maturation arrest showed the highest apoptotic index with maximum number of downregulated genes. We conclude that the loss of DNA repair genes expression in testis correlates with increased apoptosis, azoospermia and infertility. © 2019 Elsevier B.V.
Buccal versus Vaginal Graft Urethroplasty in Female Urethral Stricture: A Systematic Review and Meta-Analysis
(Springer Nature, 2025) Lalit Kumar; Anuja Thakur; Sakshi Agarwal; Mahesh R. Khairnar; Sameer Trivedi; Satya Narain Shankhwar
Introduction and Hypothesis: This study is aimed at comparing success rate, maximum flow rate (Qmax), and post-void residual volume (PVR) between the buccal mucosal graft (BMG) and vaginal wall graft (VWG) through a meta-analysis of studies commonly performed by urogynecologists. Methods: A systematic review was performed in April 2024, including retrospective, prospective, and comparative studies excluding duplicates, review, editorial comments, case reports, systematic reviews, meta-analyses, and therapeutic indications. Heterogeneity in the meta-analysis was assessed using I2 statistics. Results: The meta-analysis incorporated a quantitative assessment of 18 original articles. The studies in meta-analysis evaluated various parameters, including Qmax, PVR, and success rates of surgical outcomes. The I2 statistics indicated no heterogeneity in Qmax and success rates between BMG and VWG, both with I2 = 0% and high heterogeneity for PVR values (I2 > 50%). According to the results, Qmax values were 23.266 for BMG and 24.945 for VWG, PVR values were 14.651 for BMG and 23.009 for VWG, and success rates were 86.2% for BMG and 89.8% for VWG. A definition of success across the studies was established by achieving Qmax > 15 ml/s at 3 months, a PVR < 30 ml, and an improvement in the American Urological Association symptom scores. Conclusions: Meta-analysis indicates no significant differences between VWG and BMG regarding Qmax, PVR, and the overall success rate of surgical outcomes. Both BMG and VWG graft options demonstrate effectiveness in female urethroplasty. Graft choice should be based on graft availability and feasibility, patient characteristics, and the surgeon’s preference and expertise. © The Author(s), under exclusive license to International Urogynecological Association 2025.
Chromosome microarray analysis: A case report of infertile brothers with CATSPER gene deletion
(Elsevier, 2014) Deepika Jaiswal; Vertika Singh; U.S. Dwivedi; Sameer Trivedi; Kiran Singh
We present the case of two brothers who were referred to a male infertility clinic for infertility workup. Conventional chromosome analysis and Y chromosome microdeletions did not reveal any genetic alterations. We utilized the chromosome microarray analysis (CMA) to identify novel and common variations associated with this severely impaired spermatogenesis cases. CMA specific results showed a common deletion in the 15q15.3 region that harbors genes like CATSPER2, STRC and PPIP5K1 in both cases (M18 and M19). In addition we identified small duplication in X and 11 chromosomes of M19. This is the first familial case report from India on occurrence of CATSPER gene deletion in human male infertility. © 2014 Elsevier B.V.
Clinical epidemiology of young men with lower urinary tract symptoms: The SciCOM 3 project
(Wolters Kluwer Medknow Publications, 2025) Sanjay Sinha; Sameer Trivedi; Ankur Mittal; Girdhar Singh Bora; Rishi Nayyar; Pawan Vasudeva; Anita Patel; Harbans Bansal; Vijay Kumar Sarma Madduri; Niraj Kumar; Swarnendu Mandal; Vikash Kumar; Sujith Mathew Jose; Girish G. Nelivigi; Anil Elhence; Harprit Singh
Introduction: A study was performed to determine the most common and most bothersome symptoms and clinical associations in young men (18-40 years) presenting with lower urinary tract symptoms (LUTS). Methods: Cross-sectional study was conducted across 16 centers. Urinary symptoms, impact of bladder problems, bowel symptoms, erectile dysfunction, premature ejaculation, bladder pain, non-bladder myofascial pain, and general well-being were assessed by validated questionnaires. Results: A total of 448 men (median age 30 years) were included. Nocturia ≥1 (89.1%) and feeling of incomplete bladder evacuation (76.6%) were the most common symptoms while the most bothersome symptoms were daytime frequency and nocturia (median score 5; interquartile range 2-8, for both) on the International Consultation on Incontinence Questionnaire for Male LUTS questionnaire. Bladder symptoms were associated with severe or many severe problems (response 5 or 6, on the Patient Perception of Bladder Conditions Questionnaire) in 17.8% of the patients. Men between 18 and 20 years reported greater bother with their bladder condition. Normal erections and 'very good' control over ejaculation were reported by 49.8% and 15.6%, respectively. Constipation and loose stools were reported by 22.8% and 12.9%, while bladder pain and non-bladder myofascial pain were reported by 72.5%, and 48.2%, respectively. 17.0% of the patients reported low scores on the WHO-5 Well-Being Scale. Two distinct patient clusters were identified. A larger cluster (63.9%) that presented with voiding symptoms and urgency but fewer sexual or pain symptoms, and a smaller cluster that showed pronounced sexual symptoms, pain, daytime frequency, and nocturia. Conclusions: The most common urinary symptoms in young men are nocturia and a sense of incomplete evacuation. Daytime frequency and nocturia are the most bothersome symptoms. It is important to assess associated symptoms in young men presenting with LUTS. © 2025 Indian Journal of Urology.
Combined effect of GSTT1 and GSTM1 polymorphisms on human male infertility in North Indian population
(2012) Deepika Jaiswal; Ravindra Sah; Neeraj K. Agrawal; U.S. Dwivedi; Sameer Trivedi; Kiran Singh
Genes of different pathways regulate spermatogenesis, and complexity of spermatogenic process indicates that polymorphisms or mutations in these genes could cause male infertility. Detoxification pathway is involved in the regulation of spermatogenesis by reducing oxidative stress and contributes to the maintenance of global methylation in concert with other pathways. Glutathione S-transferases (GSTs) belong to the family of phase II antioxidant enzymes involved in the cellular detoxification of various physiological substances. Glutathione S-transferases act as an antioxidant and protect spermatozoa from oxidative stress. Increase in the levels of reactive oxygen species (ROS) along with reduced activity of GSTs may result in sperm membrane damage and DNA fragmentation. A case-control study was done to elucidate the role of deletion polymorphism of GSTT1 and GSTM1 genes from GSTs family on idiopathic human male infertility. The study comprises 2 groups: 113 nonobstructive azoospermia patients and 91 healthy fertile controls. Genomic DNA was analyzed by polymerase chain reaction for GSTT1 and GSTM1 genes. The study showed statistically significant protective association of GSTT1 null genotype with human male infertility (odds ratio [OR]: 0.3, 95% confidence interval [CI] 0.143-0.9966, P =.048) but not with GSTM1 null genotype (OR: 0.66, 95% CI 0.3653-1.2234, P =.19). Also, combination of null genotypes of GSTM1 and GSTT1 confers protective effect (OR: 0.28, CI 0.0801-0.948; P =.04). Probably, individuals bearing GSTM1 and GSTT1 (-/-) genotypes may have protective effect by gene-gene interaction mechanism. In summary, our study underscores the significance of combined effect of GSTT1 and GSTM1 null genotypes in modulating the risk of male infertility. © The Author(s) 2012.
Comparison of Guy’s vs S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNL
(SAGE Publications Ltd, 2017) V.S. Rathee; H.C. Vivek; Sartaj Wali Khan; A.K. Singh; Pushpender Kumar Shukla; Ashish Verma; Sameer Trivedi; Udai Shankar Dwivedi
Introduction and objective: The aim of the present study was to compare the accuracy of the Guy’s and S.T.O.N.E. scoring systems in predicting percutaneous nephrolithotomy (PCNL) outcomes. Methods: This prospective study was carried out in the Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between August 2013 and September 2015 in collaboration with the Department of Radiodiagnosis and Imaging. A total of 100 cases of renal calculi operated on with PCNL were considered in the study on the basis of CT morphodensitometry. The study was approved by the institute’s ethical committee. Guy’s and S.T.O.N.E. scoring systems were calculated. Regression analysis and ROC curves were performed. Results: A total of 100 PCNLs were operated on. The overall stone-free rate was 90% with a complication rate of 17%. When compared to patients with residual fragments, stone-free patients had significantly lower Guy’s grade (3.5 vs 2; p < 0.001) and S.T.O.N.E. score (9.1 vs 7.5; p = 0.023). Logistic regression analysis showed that both Guy’s and S.T.O.N.E. systems were significantly associated with stone-free status, OR 0.96 (p < 0.001) and OR 0.94 (p < 0.001), respectively. Furthermore, both scoring systems were significantly associated with estimated blood loss (p = 0.02 and p = 0.004). There was good correlation between both scoring systems and operative time (r = 0.2, p < 0.002 and r = 0.3, p < 0.002) and length of hospital stay (r = 0.1, p = 0.002 and r = 0.2, p < 0.002). There were significant associations between both scoring systems and complications (p < 0.001 and p = 0.004). There was no significant difference in the areas under the curves for the Guy’s and S.T.O.N.E. scoring systems (0.96 (95% CI 0.92–0.99) vs 0.94 (95% CI 0.89–1.001); p < 0.001). Conclusion: Both Guy’s and S.T.O.N.E scoring systems have comparable accuracies in predicting post-PCNL stone-free status. Other factors not included in either scoring system may need to be incorporated in the future to increase their accuracy. © 2017, © British Association of Urological Surgeons 2017.
Cutaneous metastases of prostatic adenocarcinoma
(Wolters Kluwer Medknow Publications, 2015) Shashikant C.U. Patne; Bitan Naik; Pranab Patnaik; Sameer Trivedi
Prostatic adenocarcinoma (PA) is a common visceral malignancy of elderly men. Cutaneous metastasis of PA is rare. The incidence is <1%. A 55-year-old man presented with urinary symptoms and multiple cutaneous nodules around suprapubic region, inner aspect of both thighs and scrotum. Fine-needle aspiration cytology (FNAC) of cutaneous nodules was suggestive of metastatic adenocarcinoma. Skin and prostatic biopsies confirmed the cytological diagnosis. Serum level of prostate specific antigen was raised. Total prostatectomy revealed adenocarcinoma of Gleason's score 7 (3 + 4). Though rare, cutaneous metastases of PA must be known to cytopathologists. Meticulously performed FNAC in such cases may help in early diagnosis.
Does preoperative urodynamic testing improve surgical outcomes in patients undergoing the transobturator tape procedure for stress urinary incontinence? a prospective randomized trial
(Korean Urological Association, 2014) Abhinav Agarwal; Sudheer Rathi; Pranab Patnaik; Dipak Shaw; Madhu Jain; Sameer Trivedi; Udai Shankar Dwivedi
Purpose: Urodynamic studies are commonly performed as part of the preoperative work-up of patients undergoing surgery for stress urinary incontinence (SUI). We aimed to assess the extent to which these urodynamic parameters influence patient selection and postoperative outcomes.; Materials and Methods: Patients presenting with SUI were randomly assigned to two groups: one undergoing office evaluation only and the other with a preoperative urodynamic work-up. Patients with unfavorable urodynamic parameters (detrusor overactivity [DO] and/or Valsalva leak point pressure [VLPP] < 60 cm H2O and/or maximum urethral closure pressure [MUCP] < 20 cm H2O) were excluded from the urodynamic testing group. All patients in both groups underwent the transobturator midurethral sling procedure. Evaluation for treatment success (reductions in urogenital distress inventory and incontinence impact questionnaire scoring along with absent positive stress test) was done at 6 months and 1 year postoperatively.; Results: A total of 72 patients were evaluated. After 12 patients with any one or more of the abnormal urodynamic parameters were excluded, 30 patients were finally recruited in each of the “urodynamic testing” and “office evaluation only” groups. At both the 6- and the 12-month follow-ups, treatment outcomes (reduction in scores and positive provocative stress test) were significantly better in the urodynamic testing group than in the office evaluation only group (p-values significant for all outcomes).; Conclusions: Our findings showed statistically significantly better treatment outcomes in the urodynamic group (after excluding those with poor prognostic indicators such as DO, low VLPP, and MUCP) than in the office evaluation only group. We recommend exploiting the prognostic value of these urodynamic parameters for patient counseling and treatment decisions. © The Korean Urological Association, 2014.
Does the consistency of stools define a distinct patient cohort in young men presenting with severe lower urinary tract symptoms?
(Wolters Kluwer Medknow Publications, 2025) Sanjay Sinha; Ankur Mittal; Sameer Trivedi; Harbans Bansal; Girdhar Singh Bora; Rishi Nayyar; Pawan Vasudeva; Anita Patel; Vijay Kumar Sarma Madduri; Niraj Kumar; Swarnendu Mandal; Vikash Kumar; Sujith Mathew Jose; Girish G. Nelivigi; Anil Elhence; Harprit Singh
Introduction: Constipation has long been recognized to be associated with lower urinary tract symptoms (LUTS). However, there is little clinical data on bowel symptoms in young men who present with LUTS. This study analyses the association of stool consistency with severe LUTS in young men. Methods: This study is a secondary analysis of SciCOM 3 study examining young men presenting with LUTS. Stool consistency was recorded by the Bristol Stool Chart and classified into hard stools (Class 1, 2), normal stools (Class 3, 4), and loose stools (Class 5–7). LUTS, sexual dysfunction, bladder pain, non-bladder myofascial pain, perception of problems related to the bladder, and general well-being were captured by questionnaires along with basic clinical data. The poorest score on every question of each questionnaire was categorized as “severe”. Results: Four hundred and forty-eight young men (18–40 years; median 30 years, interquartile range 25–35 years) were studied across 16 centers. Stool consistency was hard, normal, and loose in 105 (23.4%), 284 (63.4%), and 59 (13.2%), respectively. Constipation was not associated with severe LUTS. Loose stools showed an association with six of the 13 questions on the International Consultation on Incontinence Questionnaire for male LUTS. Erectile dysfunction, bladder and nonbladder pain, and general well-being were found to be associated with loose stools but not with constipation. On multinomial logistic regression analysis, recurrent urinary tract infection and low body mass index were associated with hard stools, while low maximum flow rate, severe erectile dysfunction, and severe myofascial pain were associated with loose stools. Conclusions: Loose stools are an important association in young men presenting with severe LUTS. © 2025 Indian Journal of Urology.