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Sreekantha,Navodaya Medical College | Kowsalya R.,Institute of Nephrourology | Avinash S.S.,Father Muller Medical College | Chandran V.,Kasturba Medical College | And 2 more authors.
Biomedicine | Year: 2011

Objectives: Proteins modified under oxidative stress seem to play a pivotal role in pathogenesis of several diseases. The present study was undertaken to know the relation between protein carbonylation and antioxidants in the form of glutathione and albumin in rheumatoid arthritis patients. Methods: Protein carbonylation & glutathione levels were measured in plasma in all the 30 patients and 25 controls using spectrophotometric methods along with total protein and albumin. Results: There was significant increase in protein carbonylation content (P<0.001) associated with a significant decrease in glutathione and albumin levels (P<0.001) in patients compared to healthy controls. A significant negative correlation of protein carbonylation with glutathione and albumin was also noted. Conclusion: Thus our study suggests a possible role for oxidatively modified proteins in form of protein carbonyls in mediation of inflammation in rheumatoid arthritis leading to increased consumption of available antioxidants in the body.


Bhat M.A.,Indira Gandhi Medical College and Research Institute | Sageerabanoo S.,Aarupadai Veedu Medical College | Kowsalya R.,Institute of Nephrourology | Sarkar G.,Subharathi Medical College
Journal of Clinical and Diagnostic Research | Year: 2012

Introduction: The Extended Spectrum Beta Lactamases (ESBLs) are the class A plasmid mediated enzymes that hydrolyze the oxyimino-cephalosporins and the monobactams but not the cephamycins and they are inhibited by clavulanic acid. In the recent years, the CTX-M type are the most common ESBLs which have been isolated. The present study was undertaken to know the prevalence of the ESBL producing E. coli in urinary tract infections (UTIs) and also to know the occurrence of the CTX-M3 genotype among these E. coli which were isolated in our hospital. Materials and Methods: The routine antimicrobial susceptibility testing was done for the E. coli which were isolated from the urine samples. The strains of E. coli that were resistant to cefotaxime and ceftriaxone were selected for the ESBL testing. The strains were tested for ESBL production by the Double Disc Synergy Test (DDST) and the phenotypic confirmatory double disc test (PCDDT) as per the CLSI guidelines. Fifty four isolates of E. coli were found to be positive for ESBL by the phenotypic methods, out of which fifty isolates were tested for the presence of CTX-M3 by PCR and also their minimum inhibitory concentrations (MICs) for ceftazidime were determined. Results: Out of a total of 157 E. coli isolates, 54 isolates (34.4%) were found to be positive for ESBL by the phenotypic methods, DDST and PCDDT. Nearly 21(38.8%) ESBL positive E. coli isolates had an MIC of ≥ 128μg/ml for ceftazidime. Out of the 50 strains of ESBL positive E. coli that were run for PCR, 42(84%) were positive for the CTX-M3 gene. Conclusion: Our study showed that the ESBL producing urinary isolates of E. coli were not only resistant to the third generation cephalosporins but also to ciprofloxacin, cotrimoxazole and gentamicin. The occurrence of the CTX-M3 genotype was high among the E. coli isolates in our study.


Bhat G.,Institute of Nephrourology | Raviraj M.B.,Institute of Nephrourology | Jayaram S.,Institute of Nephrourology | Siddalingaiah I.,Vanivilas Hospital | Huchappa N.N.,Institute of Nephrourology
UroToday International Journal | Year: 2011

Androgen insensitivity syndrome (AIS), also known as testicular feminization, encompasses a wide range of phenotypes that are caused by numerous different mutations in the androgen receptor gene. AIS is an X-linked recessive disorder that is classified as complete, partial, or mild based on the phenotypic presentation. The clinical findings include a female type of external genitalia, 46-XY karyotype, absence of Müllerian structures, presence of Wolffian structures to various degree, and normal to high testosterone and gonadotropin levels. The syndrome is illustrated by a 24-year-old phenotypic female who presented with an inability to conceive, normal-appearing external genitalia, an absent uterus and ovaries, and bilateral testes at the level of the internal inguinal ring. Management includes counseling, gonadectomy to prevent primary malignancy in undescended gonad, and hormone replacement. The karyotyping of family members is advocated because of known familial tendencies. © 2011 UroToday International Journal.


Hima Mani H.,Institute of Nephrourology | Shivaprasad S.M.,Institute of Nephrourology | Umesh L.,Institute of Nephrourology
Journal of Clinical and Diagnostic Research | Year: 2016

Systemic lupus erythematosus (SLE) is associated with various neurologic or psychiatric abnormalities and Posterior Reversible Leuco Encephalopathy Syndrome (PRES) is very rare neurological manifestation in SLE. PRES is associated with various clinical manifestations, like, seizures, visual loss, headaches, vomiting altered mental status and rarely focal neurological deficits. Other predisposing condition associated with PRES is eclampsia, accelerated hypertension, uraemia, transplantation, autoimmune diseases and/or use of immunosuppressive drugs. It is important to recognise PRES since it is a potentially reversible. We describe an unusual case of PRES caused by uraemia during lupus flare up in a patient with biopsy proven class IV lupus nephritis who presented with features of asymmetrical quadriparesis which completely reversed after haemodialysis sessions and treating lupus flare up. In our case she presented with quadriparesis which is a rare presentation and hypertensive encephalopathy was not present. © 2015, Journal of Clinical and Diagnostic Research. All rights Reserved.


Bhat G.,Institute of Nephrourology | Nelivigi G.,Institute of Nephrourology | Shivalingiah M.,Institute of Nephrourology | Ratkal C.,Institute of Nephrourology
UroToday International Journal | Year: 2011

Dysfunctional voiding is incontinence resulting from voiding-phase dysfunction. It has been associated with various disorders, but there are only 2 known reports of dysfunctional voiding as a presenting feature of Marfan syndrome in the literature. The present case is a 16-year-old boy with dysfunctional voiding who was diagnosed as having failure to void due to sphincter dyssynergy associated with an unsafe bladder, left-sided vesicoureteric reflux, and emerging Marfan syndrome. Diagnosis of Marfan syndrome was based on the number and type of his clinical features. Because of the prohibitive cost of regular botulinum toxin injections to the sphincter in India, the patient's dysfunctional elimination was managed with clean intermittent self-catheterization, anticholinergics, and stool softeners. Follow-up included monitoring the thorax for any signs of increasing aorta size. It is important to predict dysfunctional elimination in children born with any syndrome that has generalized hypermobility of the joints. © 2011 UroToday International Journal/Vol 4/Iss 1/February.


Bhat G.S.,Institute of Nephrourology | Nelivigi G.G.,Institute of Nephrourology | Ratkal C.S.,Institute of Nephrourology | Venkatesh G.K.,Institute of Nephrourology
UroToday International Journal | Year: 2011

INTRODUCTION: The effect of a transurethral catheter on urodynamic pressure-flow studies has been questioned, especially for patients with bladder outlet obstruction (BOO). The purpose of this retrospective study was to compare urodynamic outcomes measured during free uroflowmetry with pressure-flow studies using a transurethral catheter. METHODS: We retrospectively reviewed the records of 22 adult patients who had voided volume that did not differ by more than 20% during 2 assessments: free uroflow and pressure-flow with a transurethral 5 Fr catheter in situ. The outcome measures were maximum flow (Qmax), average flow rate, voiding time, time to Qmax, and flow acceleration. Free uroflow and pressure-flow outcomes were compared using paired t tests. A Bonferroni adjustment was applied; probability <.01 was considered statistically significant. RESULTS: There were 17 males and 5 females. The mean age was 39.9 years (range, 18-80 years). The urodynamic findings were reported as: normal (n = 6), hypocontractile detrusor (n = 5), BOO (n = 5), overactive bladder symptom complex (n = 4), and low pressure-low flow system (n = 2). Qmax was significantly higher during free uroflow than during pressure-flow recordings (P = 001). Average flow rate was also significantly higher during free uroflow (P <001). Voiding time was significantly slower and acceleration was significantly faster during free uroflow (both with P =001). There was no significant difference between recording conditions in the time to Qmax. CONCLUSION: There appears to be a significant decrease in some uroflow measurements with a 5 Fr urethral catheter in situ during pressure-flow studies, which is contrary to the previous claim that any catheter smaller than 6 Fr does not alter the results. This measurement artifact needs to be considered when interpreting urodynamic studies, particularly if the patient has BOO. To compensate for differences between the free uroflow rate and uroflow rate with a catheter, the free uroflow rate and detrusor pressure may need to be considered when evaluating the degree of BOO. © 2011 UroToday International Journal.


Kowsalya R.,Institute of Nephrourology | Sreekantha,Manipal University India | Chandran V.,Manipal University India | Remya,NITTE University
International Journal of Pharma and Bio Sciences | Year: 2011

Rheumatoid arthritis is a clinical condition accompanied by inflammation and oxidative stress. In this study, we compared levels of antioxidants vitamin-E and C along with lipid profile between rheumatoid arthritis patients and healthy controls. We also looked into presence of any correlation between dyslipidemia, the antioxidants vitamins and lipid peroxide product among rheumatoid arthritis patients. We found a significant fall in vitamin E and C along with raised MDA in patients compared to controls. A highly significant positive correlation was found between MDA and LDL-cholesterol (r = 0.781,P< 0.004),whereas vitamin E and C were negatively associated with MDA level (r = -0.70, P< 0.01 and r = -0.75,P< 0.001 respectively).Thus the assessment of the lipid profile, along with other cardiovascular risk factors should be actively determined and appropriate treatment along with sufficient antioxidants supplementation should form part of the standard treatment protocol in rheumatoid arthritis patients.


A 16-year-old boy underwent visual internal uretherotomy in the lithotomy position for short urethral stricture. The next day, the patient developed right foot drop and sensory loss over the right foot. Published literature describes a long surgery duration in the lithotomy position as the most significant risk factor. In our case, foot drop developed despite short surgical duration in the lithotomy position, signifying the importance of other, less-discussed factors. © 2012 Digital Science Press, Inc.


PubMed | Institute of NephroUrology
Type: Journal Article | Journal: Urology annals | Year: 2013

Long anterior urethral strictures are fairly common in developing world and the treatment is equally challenging.To assess the results and efficacy of Monsieurs Tunica Albuginea Urethroplasty (TAU) for anterior urethral stricture.We analyzed the results in 10 consecutive patients with pan-anterior urethral stricture, who underwent Monsieurs urethroplasty.The procedure involves mobilization of strictured urethra and laying it open with a dorsal slit. Edges of the slit-open urethra are sutured to edges of the urethral groove to the tunica of corporal bodies with catheter in situ. Results were assessed postoperatively 3, 6, 9 and 12 months. Patients were categorized as success and failure by comparative analysis of patient satisfaction along with urethroscopy, retrograde urethrogram, uroflowmetry. All patients were taken for post-operative urethroscopic analysis at 6 months to allow better understanding of both successful and failed cases.Mean follow-up of 15.2 (11-19) months showed an 80% success rate. Mean uroflow rate showed Qmax 24.5 cc/sec with 8 cases showing no residual or recurrent stricture. Two cases failed and required intervention. Urethroscopic visualization of the reconstruction site showed wide, patent and distensible neourethra appearing epithelized over roof formed by tunica albuginea of the corpora cavernosa in successful cases.Monsieurs TAU is effective technique in treatment of anterior urethral stricture especially cases with unavailable buccal mucosa, with results fairly acceptable at the end of one year.


PubMed | Institute of Nephrourology
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Systemic lupus erythematosus (SLE) is associated with various neurologic or psychiatric abnormalities and Posterior Reversible Leuco Encephalopathy Syndrome (PRES) is very rare neurological manifestation in SLE. PRES is associated with various clinical manifestations, like, seizures, visual loss, headaches, vomiting altered mental status and rarely focal neurological deficits. Other predisposing condition associated with PRES is eclampsia, accelerated hypertension, uraemia, transplantation, autoimmune diseases and/or use of immunosuppressive drugs. It is important to recognise PRES since it is a potentially reversible. We describe an unusual case of PRES caused by uraemia during lupus flare up in a patient with biopsy proven class IV lupus nephritis who presented with features of asymmetrical quadriparesis which completely reversed after haemodialysis sessions and treating lupus flare up. In our case she presented with quadriparesis which is a rare presentation and hypertensive encephalopathy was not present.

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