Browsing by Author "Sarita Chowdhary"

Now showing 1 - 17 of 17

A new anatomic variant of urethral duplication
(Elsevier Inc., 2018) Sarita Chowdhary; Shiv Prasad Sharma
[No abstract available]
Basic Principles of Pediatric Surgical Oncology: What Radiologist Should Know
(Springer Science+Business Media, 2025) K. Sharma; Sarita Chowdhary; Shiv Prasad Sharma; Ishan Kumar
Radiologists are integral members in the multidisciplinary care of pediatric oncology patients. Their expertise in diagnostic imaging, including X-rays, ultrasounds, MRIs, and CT scans, is essential for accurate diagnosis and treatment planning. Interpretation and diagnosis of pediatric surgical imaging require a comprehensive understanding of imaging algorithms to navigate between various tumors. The location, size, and characteristics of these abnormalities are crucial in determining the type and extent of the cancer. Surgical planning is predominantly guided by resectability and stage of tumor. Further, imaging plays a crucial role in assessing the treatment response as well as long-term surveillance of tumor. This review explores the treatment guidelines and protocols of common pediatric surgical tumors. A concise algorithms to various pediatric surgical tumors have been provided to give insight into the integrated treatment approach with approximate timelines. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Case report of a rare variant of polyorchidism
(Elsevier Inc., 2016) Sarita Chowdhary
Polyorchidism is a rare type of developmental anomaly. It is defined as presence of more than one testis on the same side. Supernumeary testis with separate epididymis and separate vas deferens is a very rare variant of polyorchidism. We present a case of triorchidism presenting as cryptoorchidism in a six month old infant which on inguinal exploration was found to have double testes with separate vas deferens and epididymis. We closely followed the patient for two years after orchidopexy and found no complications or malignant change. © 2016 The Authors. Published by Elsevier Inc.
Disorders of sexual development: structured radiological reporting and practical approach
(Springer, 2024) Ishan Kumar; Adity Prakash; Priyanka Aggarwal; Sarita Chowdhary; Ashish Verma
Disorders of sexual development (DSD) comprise a complex group of conditions with varied clinical presentations, such as atypical genitalia, non-palpable testes, primary amenorrhea, or infertility. Besides being associated with other congenital anomalies, DSDs bear substantial ethical issues regarding assigning the sex of rearing to the child and future fertility options. Establishing the correct diagnosis is essential for the appropriate management of such cases. Various imaging modalities, such as ultrasonography, genitography, and MRI, when complemented with detailed clinical evaluation and karyotyping, are the key to diagnosing the condition. This article attempts to present a concise approach to various patterns of DSD, which will aid radiologists to solve these diagnostic dilemmas. Graphical abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Endoscopic Third Ventriculostomy in Infants Less than One Year of Age: A Short Series of 14 Cases
(S. Karger AG, 2021) Sarita Chowdhary; Shyamendra Pratap Sharma; Pranaya Panigrahi; Manoj Kumar Yadav; Shiv Prasad Sharma
Background: Endoscopic third ventriculostomy (ETV) is currently considered as an alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. This procedure allows the CSF to drain in the basal cisterns and reabsorbed by arachnoid granulations, and avoiding implantation of exogenous material. Aims and Objectives: The purpose of this study was to assess the success rate of ETV in infants less than 1 year of age with congenital noncommunicating hydrocephalus. Material and Methods: This study was a 2-year prospective study from August 2017 to July 2019. ETVs were performed in 14 patients younger than 1 year with diagnosis of noncommunicating hydrocephalous. A failure was defined as the need for shunt implantation after ETV. Phase-contrast MRI of the brain was done after 6 months to see patency of ETV fenestration and CSF flow through ventriculostomy. Results: ETV was tried in 18 patients and successfully performed in 14 patients. Out of the 14 patients, shunt implantation after ETV was performed in 3 patients (failed ETV). In the successful cases, etiology was idiopathic aqueductal stenosis in 8, shunt complications in 2, and 1 case was a follow-up case of occipital encephalocele; the mean age was 7.7 months (range 3-12). In the 3 failed cases, etiology was aqueductal stenosis, mean age was 7.6 months (range 3-11). In all ETVs, failed patients MPVP shunting was done. Follow-up of nonshunted patients was done from 6 to 24 months (mean 15 months). There was no mortality or permanent morbidity noted following ETV. Conclusion: ETV is a good surgical procedure for less than 1-year-old children. © 2021 S. Karger AG. All rights reserved.
Five-year experience of anorectal malformation with oesophageal atresia in tertiary care hospital
(Wolters Kluwer Medknow Publications, 2020) Sarita Chowdhary; Pranay Panigrahi; Rakesh Kumar
Aim: We had done this study for TEF with Anorectal malformation and TEF with no Anorectal malformation in terms of age, sex, surgical outcomes and mortality. Materials and Methods: This was a retrospective review of cases with clinical data (from April 2012 to April 2017). The participants of this study were 236 patients who had been diagnosed and managed for ARM. Among these patients, 25 patients associated with EA were selected as the subject patient group. Results: The incidence of tracheoesophageal fistula with ARM was 11.1%. The study has more male preponderance. All cases are of Type c except two cases of Type a. According to the classifications of ARMs, there were two cases with rectourethral fistula and eight cases with rectoperineal fistula and covered anus in the males. In females, there was a varied distribution of seven cases. There was one case (4%) presenting as a part of the Vertebral anorectal malformation cardiac tracheoesophageal renal and limb anomalies (VACTERL) association, which is the representative example of a complex anomaly. Most of the cases died due to cardiac problem and pneumonitis (due to delayed presentation). Conclusion: The study concludes the experience of EA (±fistulae) with ARM, their distribution, incidence and outcome of the tertiary care centre. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
H-reflex conduction velocity in babies from birth to 6 month of age
(Mr Bhawani Singh, 2017) Aparna Debbarma; Priyanka Bhagat; Sarita Chowdhary; A.N. Gangopadhyay; S.P. Sharma; Udai Prakash
Background: The neurological assessment of newborn babies is clinically difficult due to its subjectivity. H-reflex and H-reflex conduction velocity (HRCV) are especially useful in pediatric nerve conduction studies. It evaluates proximal segment of nerve which includes Ia sensory afferent and motor component of the peripheral nerve. Aims and Objectives: To assess the H-reflex latency (HRL) and HRCV in first 6 months of postnatal period and their correlation with other anthropometric variable such as weight, height, and head circumference. Materials and Methods: 26 full-term babies between the age group from birth to 6 months of age were the study participants. HRL and HRCV were recorded in the right lower limbs at posterior tibial nerve-soleus muscle in all the babies. Results: The values of HRCV had significantly increased at 3-6 months of age, and it was strongly correlated with HRL but weakly correlated with age of the babies. Conclusion: The proximal nerve conduction velocity i.e. HRCV was significantly increased from birth time to 3-6 months of age due to rapid myelination and maturation of nerve fibers. This rise in velocity has also maintained the HRL to a comparable level in all the babies even with the increment of height. The HRL and HRCV could be useful as a complementary method along with clinical examination to assess functional integrity of the spinal cord. © 2017 Priyanka Bhagat, et al.
H-reflex studies in lumbosacral meningomyelocele
(Association of Physiologists and Pharmacologists of India, 2017) Priyanka Bhagat; Aparna Debbarma; Sarita Chowdhary; A.N. Gangopadhyay; S.P. Sharma; Udai Prakash
Objective of this work was to assess the effects of meningomyelocele (MMC) and its surgical intervention on spinal H-reflex. Twenty nine full term infants with age varying from 1-37 days were the study subject. Out of them 14 were normal infants and the rest were suffering from lumbosacral MMC. MMC babies were further investigated one week after surgical removal of sac. H-reflex latency (HRL) and related parameters (Hmax, Mmax and H/M ratio) were recorded at posterior tibial nerve-soleus muscle of right lower limb. H-reflex was absent in few MMC infants before surgery and their number were increased after surgery. Further, HRL and Mmax values were significantly less in MMC compared to normal infants. These observations suggest that some components of reflex arc were damaged in MMC, but the impulse conduction had increased in the viable neural tissue. Surgical intervention had limited role in restoration of neural function. © 2017, Association of Physiologists and Pharmacologists of India. All rights reserved.
Median Scrotal Mass in a Child Masquerading as Third Testis: A Diagnostic Dilemma
(Wolters Kluwer Medknow Publications, 2025) K. Sharma; Akash Mishra; Rajat Kumar Singh; Ajit Kumar Vidhyarthy; Sarita Chowdhary
[No abstract available]
MiT family translocation-associated (TFE3 positive) renal cell carcinoma of childhood
(Wolters Kluwer Medknow Publications, 2018) Richa Katiyar; Shashikant C.U. Patne; Sarita Chowdhary
[No abstract available]
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 urinary transforming growth factor beta-b1 and monocyte chemotactic protein-1 as prognostic biomarkers in posterior urethral valve
(Wolters Kluwer Medknow Publications, 2020) Pranay Panigrahi; Sarita Chowdhary; Shyamendra Pratap Sharma; Rakesh Kumar; Neeraj Agarwal; Shiv Prasad Sharma
Background: Posterior Urethral Valves (PUV) are the most common cause of congenital LUT obstruction in males. Biomarkers of glomerular or tubular injury may be of particular value in predicting the need for surgical intervention or in tracing progression of chronic kidney disease. Measurement of biomarker in urine is relatively easy. Aim: To evaluate the changes in values of urinary Transforming Growth Factor Beta 1(TGF-B1) and Monocyte Chemotactic Protein (MCP-1) before and after valve ablation and its prognostic value in Posterior urethral valve. Material and Method: This prospective study was conducted from September 2016 to August 2018. The study group included 20 consecutive male babies with the diagnosis of PUV treated and followed up versus equal numbers of age matched control without any renal or urinary tract disease. Pre-operative urine samples were collected in Operative room. Cystoscopy and valve ablation was done. Follow up was done clinically by urinary stream and radiologically with VCUG. Follow-up was planned at 1 month, 3 months and 6 months following cystoscopic valve ablation. All collected urine samples were centrifuged at 10,000 rpm for 20 minutes. Supernatant was collected and two divided aliquots were stored at -200c to be thawed on the day of assay. Optical density of each well was recorded at 450 nm and 540 nm A p-value of <0.05 was considered to be statistically significant. Result and Discussion: Out of 20 cases of PUV, 14 (70%) cases were 1st born males of their family. The median age at the time of valve ablation in PUV cases was 2.5 (1.20-3.87) years.. Most common symptoms are fever and UTI. The preoperative median serum creatinine level was 1.65 mg/dl(1.22-2.42) pre-ablation, and fall significantly after ablation. Median eGFR level (calculated) was 25.635 (16.38-35.40) and after 6 months was 71.490 (45.44-96.93). Preoperative median MCP1 in PUV cases was 147.2 (82.8-512.5) and significant difference was also found in 1st, 3rd and 6th months after surgery (p<0.001, p=0.004 and p=0.002).Preoperative median TGF-B1 level was 197.8 pg/ml (79.9-386.4). There was no statistically significant change in TGF-B1 level at preoperative to 1 month and preop to 3 months after surgery but at 6 months after surgery the median TGF-B1 level significantly decreased as compared with preoperative TGF-B1 level. Conclusion: TGF β1 and MCP1 can be considered as prognostic urinary biomarkers in patients of PUV and can be used to specify and counsel patient's attendant regarding possibility of ESRD and need for further intervention. © 2020 Journal of Indian Association of Pediatric Surgeons.
Single-stage repair versus traditional repair of high anorectal malformations, functional results' correlation with Kelly's score and postoperative magnetic resonance imaging findings
(2013) A.N. Gangopadhyaya; Vijayendra Kumar; Vijay D. Upadhyaya; Sarita Chowdhary; Arvind Srivastava; D.K. Gupta; Ashish D. Upadhyaya; S.P. Sharma; S.C. Gopal
INTRODUCTION: Posterior sagittal anorectoplasty (PSARP) is the standard treatment for anorectal malformations. In the present study, the clinical evaluation of anal continence was carried out using Kelly's scoring system and the results of primary PSARP or abdomino-PSARP were compared with the traditional three-stage procedure and the functional outcome was correlated with the findings of MRI, which was used as an objective method of evaluation. PATIENTS AND METHODS: A total of 40 patients with intermediate and high anorectal malformations were studied and were divided into two groups on the basis of a random number table. The patients in group A were treated with a single-stage operation, whereas the patients in group B were treated with a standard staged operation (either PSARP or abdominoperineal pull-through). After clinical evaluation using the Kelly score, patients were divided into three clinical groups irrespective of whether they were operated in one stage or in three stages. All patients were subjected to MRI at the age of 3 years and the findings were correlated with the clinical scoring system. RESULT: Patients were categorized according to their Kelly's scores as follows: group 1: clinically good (score 5-6); group 2: clinically fair (score 3-4); and group 3: clinically poor (score 0-2). The proportions of good development of the muscles (puborectalis, external sphincter muscle, and levator muscle hammock) were 78.9% in group 1, 40% in group 2, and none in group 3. Development of muscles was found to be a significant factor for anal continence. Other significant factors for anal continence are rectal diameter and anorectal angle. CONCLUSION: Clinical assessment using the Kelly score was similar for the single-stage operation and the staged procedure, and this was supported by MRI findings. Therefore, we recommend the single-stage procedure to achieve a better outcome in intermediate and high anorectal malformation. © 2013 Annals of Pediatric Surgery.
Spontaneous Evisceration following Ruptured Umbilical Hernia Abscess in an Infant: A Rare Case Report
(Wolters Kluwer Medknow Publications, 2025) Greeshma Suresh; Seth Kachhap; Ajit Kumar Vidhyarthy; K. Sharma; Sarita Chowdhary
Umbilical hernia is one of the most common congenital anomalies. We document an unusual event of abscess of umbilical hernia in a 5-month-old female which was associated with rupture of the hernia followed by evisceration. Immediate reduction and surgical repair were done. The case reports an uncommon trilogy of rupture of umbilical hernia, abscess, and spontaneous evisceration. © 2025 Journal of Indian Association of Pediatric Surgeons.
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.
Urinary flow rates in anterior hypospadias: Before and after repair and its clinical implication
(Wolters Kluwer Medknow Publications, 2023) Shyamendra Sharma; Sarita Chowdhary; Rakesh Kumar; Manoj Yadav; Pranay Panigrahi
Context: Hypospadias is a common urological anomaly which could be surgically corrected with good cosmetic results. Aims: We aimed to detect changes in urinary flow parameters both before and after tubularised incised plate urethroplasty (TIPU) using uroflowmetry. Settings and Design: Data collected were clinically implemented hypothesising the probability of urethrocutaneous fistula following stricture with Qmax variation. Materials and Methods: This study is a prospective analysis done from December 2017 to October 2019. A total of 104 cases of anterior hypospadias were included in the study. A single surgical unit did TIPU. Pre-operative and post-operative uroflowmetry was done, and Qmax was recorded at 3 months, 6 months and 1 year after surgery. Mean Qmax was calculated for all intervals. A significant decrease in Qmax of a child (<2 standard deviation) was ascertained. Urethral calibration was done in those cases with a significant decrease of Qmax and analysed statistically. Results: The mean age was 6.97 ± 2.41 years. Out of 104 children, 73 (70.2%) and 31 (29.8%) had distal and mid-shaft hypospadias, respectively. The pre-operative mean Qmax of the population was 6.20 ± 0.42 ml/s. Arithmetic mean Qmax at 3 months, 6 months and 1 year was 8.53 ± 0.42, 11.18 ± 0.47 and 13.71 ± 0.44 ml/s, respectively. On comparing the pre-operative with post-operative mean Qmax, a significant increase was found postoperatively (P < 0.0001). Twenty-four patients had significantly decreased Qmax value after 6 months. In these patients, follow-up urethral dilation was done with significant improvement. Conclusion: The changes in maximum flow rate (Qmax) are suitable for use in routine follow-up. A significant decrease in Qmax over time indicates the onset of urethral stricture. These cases are to be intervened before venturing to redo urethroplasty. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
Urinary KIM-1 and CA 19-9: Biomarkers for Guiding Treatment Decisions after Pyeloplasty
(Tehran University of Medical Sciences, 2025) Sunil Kumar Singh Gaur; K. Sharma; Sarita Chowdhary; Shiv Prasad Sharma; Pranay Panigrahi
Introduction Urinary biomarkers KIM-1 and CA 19-9 are being evaluated as diagnostic indicators for congenital obstructive hydronephrosis in pediatric patients. This study focuses on the quantification of these biomarkers pre-and post-surgery, correlating their levels with ultrasonographic findings and histopathological assessments to refine diagnostic accuracy and therapeutic approaches. Biomarker analysis aids in identifying candidates for surgical intervention and addresses the challenge of persistent obstruction following pyeloplasty, facilitating timely, targeted treatments to safeguard renal function. Methods This two-year prospective analysis examined urinary KIM-1 and CA 19-9 concentrations in 40 pediatric patients diagnosed with UPJO. The study cohort included individuals below 16 years of age, provided follow-up consent was obtained. A total of three cases were excluded due to either loss to follow-up or the necessity for repeat surgical intervention. Urine specimens were collected at baseline (pre-operative) and at 1, 3, and 6 months’ post-operative intervals, with biomarker quantification conducted using ELISA kits. Diagnostic evaluation included ultrasonography and nuclear imaging modalities. Statistical analyses were performed, and significance was established at P-value<0.05. Results The study included 37 cases of UPJO requiring pyeloplasty, alongside healthy controls. Among the cases, 51.3% were children aged 1–5 years, with a male predominance of 81.08%. Post-operative outcomes demonstrated a statistically significant reduction in the antero-posterior diameter (APD). Urinary biomarkers KIM-1 and CA 19-9 exhibited a notable post-operative decline, with KIM-1 showing a more substantial decrease. The sensitivity and specificity of CA 19-9 marginally exceeded those of KIM-1. Conclusions Urinary biomarkers KIM-1 and CA 19-9 effectively monitor pyeloplasty outcomes in children with congenital obstructive hydronephrosis, providing a cost-effective, child-friendly alternative to renal scans, ensuring timely interventions, safeguarding kidney function, and reassuring families. © 2025 Urology Research Center (URC), Tehran University of Medical Sciences.