Browsing by Author "U.S. Dwivedi"

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A decade's experience with vesicovaginal fistula in India
(Springer London, 2007) Neeraj K. Goyal; U.S. Dwivedi; N. Vyas; M.P. Rao; S. Trivedi; P.B. Singh
A retrospective analysis of 252 cases of vesicovaginal fistulae was done to analyse its etio-pathology and management in an Indian population. After a thorough evaluation, different techniques of fistula closure were used for repair and the results were listed. The main outcome measures were the etiology of the fistula, need for tissue interposition and cure rate per repair as well as the overall cure rate. We compared our results with literature and concluded that simple and small fistulae should be repaired with layered closure. All complicated fistulae should be repaired with tissue interposition or tissue graft. This is the first study from India compiling 10 years of experience on vesicovaginal fistula. © International Urogynecology Journal 2006.
Anuria in advanced carcinoma of prostate: Role of methyl prednisolone - A case report
(2003) Vibhav Malviya; Gopi Kishore; Arif Hameed; U.S. Dwivedi; P.B. Singh
[No abstract available]
Artificial neural networks in predicting optimum renal stone fragmentation by extracorporeal shock wave lithotripsy: A preliminary study
(2003) A. Hamid; U.S. Dwivedi; T.N. Singh; M. Gopi Kishore; M. Mahmood; H. Singh; V. Tandon; P.B. Singh
OBJECTIVE: To assess the ability of artificial neural networks (ANNs) to predict optimum renal stone fragmentation in patients being managed by extracorporeal shock wave lithotripsy (ESWL). PATIENTS AND METHODS: The study included 82 patients with renal stones who were being treated by ESWL. Data (input and output values) from 60 patients in whom there was optimum fragmentation of stones by ESWL were used for training the ANN. These data mainly included the 24-h urinary variables, the radiological features of the stone disease and the ESWL settings used. The predictability of the trained ANN was tested on 22 subsequent patients, by supplying the input variables of the 22 patients into the trained ANN and recording the output values (predicted values). After subjecting these patients to ESWL, the actual results (observed values) were recorded. The predicted and the observed values were then compared. RESULTS: In the 22 patients in whom predictability was tested, the trained ANN predicted optimum fragmentation at ≤13 000 shocks/stone (as per study protocol) in 17 and optimum fragmentation at >13 000 shocks/stone in the other five. In the 17 patients (test set) where the trained ANN had predicted optimum fragmentation at ≤13 000 shocks/stone, the optimum fragmentation was at that value, although the predicted and observed values were not identical. The overall correlation between the predicted and the observed values was 75.5% (correlation coefficient 0.7547) in these 17 patients. Of the other five patients, none had optimum fragmentation at <13 000 shocks/stone, as predicted by the trained ANN, giving complete accuracy for this factor. CONCLUSION: This was a pilot study, i.e. an initial attempt to use an ANN in this regard, and although there were few patients, such that it is not possible to make final recommendations, the overall predictability was ≈75%. An encouraging outcome of the study was that the trained ANN identified patients unlikely to benefit from ESWL. Using a larger dataset and identifying more significant variables, while eliminating inputs with a negative effect, the efficiency and utility of this ANN can probably be enhanced and in future it might be possible to predict stone fragmentation with reasonable accuracy.
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 value of fine needle aspiration cytology and biopsy in the evaluation of male infertility... A comparative study of 60 infertile patients
(2004) Mufti Mahmood; Jagdishwar Kumar Singh; U.S. Dwivedi; Mohan Kumar; P.B. Singh
To compare the diagnostic value of cytological smears of fine needle aspirate with that of histological sections obtained by testicular biopsy in the evaluation of infertility, 60 patients of infertility with azoospermia and severe oligospermia (sperm counts of <5 million/ml) were undertaken for the study. A detailed history was taken and the duration and type of infertility whether primary or secondary was noted. A thorough general physical examination included the examination of the genitalia. Testicular samples were obtained by fine-needle aspiration using a 10 ml syringe and 21-gauze needle. The samples were fixed in 95% alcohol and stained with papanicoloau stain. A testicular biopsy was taken after exploring the same tract and these sections were stained with haematoxylin and eosin. The cytological smears and histological sections were examined separately and the results compared. The cytological smears were divided into four groups: normal, with all spermatogenic cells present, hypospermatogenesis; spermatogenic arrest and sertoli cell only syndrome. There was 95% correlation between the diagnosis on the cytological smears and histological sections. However, there was some discrepancy in hypospermatogenesis and maturation arrest groups, they being difficult to diagnose even on histology.
Color Doppler ultrasonography: Its role in detection and treatment outcome in infravesical obstruction
(2003) Saleem Wani; Arif Hamid; M. Gopi Kishore; Vibhav Malviya; U.S. Dwivedi; P.B. Singh
Bladder weight and detrusor blood perfusion increases significantly with infravesical obstruction (IVO) and release of obstruction results in reduction of bladder weight and detrusor blood flow. 38 patients with IVO were subjected to color Doppler ultrasonography (CDU) to detect the blood flow in the hypertrophied detrusor-muscle. Blood flow was detected in 84.5% (Fisher exact probability <0.001). After surgical relief of obstruction, blood flow remained positive in 21.05% patients at 3 months and 13.10% patients at 6 months, which was because of persistence of IVO. Color Doppler ultrasonography (CDU) is a simple and non-invasive tool which can help in diagnosis and follow-up of infravesical obstruction.
Combined augmentation ileo-cystoplasty and ileal replacement of ureter in advanced genitourinary tuberculosis: Modified technique
(2002) P.B. Singh; Harbans Singh; Arif Hamid; Gopi Kishore; U.S. Dwivedi
An advanced case of genitourinary tuberculosis presenting with small capacity bladder, left ureteric stricture and nonfunctioning right kidney was managed with modified technique of combined augmentation ileo-cystoplasty and ileal replacement of left ureter. This complex and extensive reconstruction can be done easily and successfully in a short time with our modified technique.
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.
Congenital Mucus Retention Cyst of Penis Presenting as Skin Papilloma
(2007) Neeraj Kumar Goyal; S. Trivedi; U.S. Dwivedi; P.B. Singh
[No abstract available]
Current role of trans rectal ultrasonography (TRUS) of prostate
(2001) Wani M. Saleem; P.B. Singh; U.S. Dwivedi
[No abstract available]
Dorsal onlay buccal mucosal graft urethroplasty in long anterior urethral stricture
(Brazilian Society of Urology, 2007) Biswajit Datta; M.P. Rao; R.L. Acharya; N. Goel; Vaibhav Saxena; S. Trivedi; U.S. Dwivedi; P.B. Singh
Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in long anterior urethral stricture (> 2 cm long) through the midline perineal incision. Materials and Methods: From January 1998 to December 2003, 43 patients with long anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 months with uroflowmetry retrograde urethrogram (RGU) and American Urological Association symptoms score (AUA symptoms scores). Successful outcome was defined as normal voiding with a maximum one attempt of VIU after catheter removal. Patients were further followed-up with uroflowmetry at 3 months interval and RGU every 6 months interval. Results: Mean stricture length was 4.8 cm (range 3 to 9 cm) and mean follow up was 48 months (range 12 to 84 months). Only five patients were found to develop stricture at anastomotic site, during follow-up. Two of them voided normally after single attempt of VIU. Other three patients (6.9%) required further open surgery or repeat VIU during follow up and were considered as failure. Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.
Early posttransplant erythrocytosis in renal allograft recipients
(2010) Jai Prakash; Shivendra Singh; Sanjeev Kumar Behura; Biplab Ghosh; L.K. Sharatchandra; U.S. Dwivedi
Posttransplant erythrocytosis (PTE) is defined as a persistently elevated hematocrit to a level greater than 51% after renal transplantation. It usually develops 8 to 24 months after transplantation. We report occurrence of PTE in two male renal allograft recipients within first 8 months of transplantation. © JAPI.
Experience with plaque excision and dermal grafting in the surgical treatment of Peyronie's disease
(2008) N.K. Goyal; A. Kumar; S.K. Das; A.K. Pandey; G.K. Sharma; S. Trivedi; U.S. Dwivedi; Pratap Bahadur Singh
Introduction: Peyronie's disease is a common cause of sexual dysfunction. We assess the technique of plaque excision and dermal grafting for the treatment of Peyronie's disease. Methods: A total of 11 patients, aged 38-55 years, were operated for Peyronie's disease. All patients had stable plaque on the dorsum or dorsolateral aspect of the penile shaft. All patients had penile curvature, nine (81.8 percent) had painful erections, six (54.5 percent) had penile pain and three (27.3 percent) had erectile dysfunction. All suffered difficulty in intercourse. We performed plaque excision and dermal grafting. Main outcome measures were relief of penile pain, relief of painful erection, performance of satisfactory coitus and straight penis while erection. Results: All patients had relief of penile pain and painful erection. Nine (81.8 percent) patients had straight penis and had satisfactory coitus. Two (18.2 percent) patients suffered postoperative erectile dysfunction which was mild and responded to Sildenafil tabs. Conclusion: Although experience with this technique is limited, the initial results are encouraging. We found this technique feasible with satisfactory results.
Fat-soluble vitamin profile in filarial chyluria - A preliminary study
(1999) M. Sridhar; D.K. Pal; I.D. Saxena; U.S. Dwivedi; V.N.P. Tripathi; P.B. Singh
[No abstract available]
Filarial chyluria: Long-term experience of a university hospital in India
(2004) Vipul Tandon; Harbans Singh; U.S. Dwivedi; Mufti Mahmood; P.B. Singh
Background: Filariasis is an endemic problem in various Indian states. We evaluated the results of long-term follow up (10-20 years) of patients with filarial chyluria. Methods: We conducted a retrospective analysis of 160 patients treated for filarial chyluria who presented to the Banaras Hindu University Hospital from 1982 to 1992. Eighty-four patients (52.5%) were treated using diethylcarbamazine (DEC) and a fat restricted diet and 76 patients (47.5%) underwent surgery. To examine the long-term effects of filarial chyluria we analysed data on post-treatment recurrence, weight gain, dietary freedom, chyluria free period and a number of other associated factors. Results: Previous history of filariasis or its complication was documented in 19% of patients. In 71% of cases, cystoscopy showed that chylous efflux was predominant in the left ureteric orifice. The long-term remission rate was 62% in the conservatively managed group (DEC + fat restricted diet), whereas 90% of patients in the operated group were cured. Postoperative recurrence rate was 10%. There was more weight gain and dietary freedom along with a longer chyluria free period in the operated group relative to the conservatively managed group. Conclusions: Definitive surgical ablation of lymphatic urinary fistula is better than conservative medical management because it has a higher success rate, more dietary freedom and, therefore, better patient acceptability.
Foreign body in bladder: A diagnostic dilemma
(2005) Mufti Mahmood; Vipul Tandon; U.S. Dwivedi; P.B. Singh
Foreign bodies in bladder being unusual in the clinical setting present as a diagnostic dilemma with the history being vague as highlighted by the present case of a 28 years old female who was found to have multiple long rubber tubings coiled together in the bladder. Cystoscopic retrival was not possible as the rubber tubings had formed a huge coiled mass. The tubings were removed by a suprapubic cystostomy. Postoperative period was uneventful.
Ileal neo-bladder: A decade experience with "pouch first and ileal neo-urethra": Our modification
(2004) P.B. Singh; Mufti Mohmood; Vipul Tandon; M. Prasada Rao; Nachiket Vyas; P.R. Nandy; Biswajeet Dutta; U.S. Dwivedi
Objective: To show the efficacy and ease of our modified technique of constructing orthotopic neo-bladder after radical cystectomy for carcinoma bladder. Materials and methods: A total number of 76 patients with invasive carcinoma of bladder underwent radical cystectomy and orthotopic neo-bladder construction at this tertiary care hospital. We modified the conventional Hautman's technique. In this we constructed the ileal pouch first on the abdominal surface after making a neo-urethra utilizing a "U" shaped flap of dependent ileal segment. Then at the end of the procedure, anastomosis is performed between the neo-urethra and the membranous urethra. These cases are followed up at regular intervals with usual protocols with special stress on uroflowmetry and complete urodynamic assessment in selected patients. Results: Out of 76 patients who had a follow up of more than 10 years, only 1 patient developed total incontinence, which developed early local recurrence. Day and night time continence rates were achieved in 95 and 90%, respectively. All patients have shown good urodynamic characteristics and normal upper tracts without vesicoureteral reflex. Conclusion: This new modified technique of making the pouch first on the surface with urethral anastomosis as a last step avoids accidental disruption, offers technical simplicity and substantially shorterns the operative time. This makes the procedure safer even in the hands of less experienced urologists without compromising continence rates.
Infant feeding tube as an aid to optical internal urethrotomy
(1999) S.S. Samaiyar; U.S. Dwivedi; P.B. Singh
[No abstract available]
Inflammatory malignant fibrous histiocytoma of kidney: A case report
(2008) Amrita Ghosh; U.S. Dwivedi; Abhay Kumar
Among the renal sarcomas, inflammatory malignant fibrous histiocytoma (MFH) is an extremely rare presentation. A 45-year-old woman presented with acute retention urine following an episode of gross hematuria. Computerized tomography showed a solid mass at the lower pole of the left kidney. The patient underwent left nephrectomy. Histologically and immunohistochemically, the tumor was diagnosed as an inflammatory subtype of MFH. Histological appearances of inflammatory MFH vary widely and frequently overlap with benign reactive conditions such as Xanthogranulomatous pyelonephritis (XGPN) and malignant lesions, e.g. malignant lymphoma and, less frequently, a sarcomatoid variant of renal cell carcinoma. It is important, though difficult, to differentiate inflammatory MFH from these lesions. Careful morphological examination and immunohistochemical findings of the lesion are of great value, in particular in excluding it from its mimics. We discuss the pathological features and challenges involved in differentiating inflammatory MFH from its masquerader. © 2008 Elsevier GmbH. All rights reserved.
Influence of demographic and clinical factors on surgical outcomes of the transobturator tape procedure in patients with stress urinary incontinence
(S. Karger AG, 2015) Abhinav Agarwal; Pranab Patnaik; Dipak Shaw; Vazir Rathee; Sartaj W. Khan; Madhu Jain; Sameer Trivedi; U.S. Dwivedi
Background: Stress urinary incontinence (SUI) is a prevalent problem within the female population with associated high psycho-social impact. Transobturator tape procedure is a well-established procedure to treat the same, but the results may be influenced by various preoperative demographic and clinical factors. Patients and Methods: The study group comprised of 50 female patients with genuine SUI, who were then divided into subgroups based on demographic and clinical factors. Outcomes were compared between these subgroups at 6 and 12 months using self-reported questionnaires and provocative stress test. Results: Our results show positive correlation with statistically significant better surgical outcomes in premenopausal patients, patients aged <50 years and those having urethral mobility > 30 degrees. Statistically significant poor outcomes were seen in those having undergone hysterectomy or Caesarean section. No correlation was found with history of smoking or the patient's body mass index. Conclusions: In conclusion, the transobturator tape procedure appears to be more effective in premenopausal women, women aged < 50 years, women without history of hysterectomy/lower section Caesarean section, and presence of urethral hypermobility > 30 degrees. On the other hand, outcomes do not appear to be influenced by the patient's body mass index or smoking status. © 2015 S. Karger AG, Basel.