Browsing by Author "Sunil Kumar Singh Gaur"

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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.
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.
“Why Break the Y”: A Novel Technique for Retrieval of an Impacted Airway Foreign Body
(Wolters Kluwer Medknow Publications, 2025) Bhanumurthy Kaushik Marripati; Akash Mishra; Sunil Kumar Singh Gaur; Vaibhav Pandey
Airway foreign body aspiration, particularly in the pediatric population, poses a critical and time-sensitive emergency due to the potential for rapid decompensation. We report a rare and challenging case of a Y-shaped fish bone lodged in the subglottic airway of a 3-year-old child, and a novel, innovative endoscopic retrieval technique was conceptualized on the table and employed to retrieve it. This case underscores the importance of individualized airway management strategies in complex pediatric airway foreign body cases. © 2025 Journal of Indian Association of Pediatric Surgeons.