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Background: Nephrolithiasis is major problem in India. It is more prevalent in northern states of India and Karnataka is not an exception to this. Percutaneous nephrolithotomy (PCNL) has been accepted globally as a safe procedure with great success rate with less complication, and it is safe, effective, and suitable for pediatric cases. The aims and objectives of the study were to evaluate the indication of PCNL in children, to identify the complication, prevention and treatment of complication and to evaluate the efficacy and safely, management of kidney stones in children.Methods: Study period Aug 2015 July 2018, total 56 cases of renal stones in pediatric age group admitted in our Hospital, a tertiary care centre. All the patients evaluated for complete urine analysis, urine culture and sensitivity, complete hemogram, renal parameter, X ray KUB (kidney, ureter, and bladder), ultrasound KUB etc.Results: Small-stone (<2 cm) seen in 21.4% and large stone 64.2%. Following complications were noted- Pelvic perforations (3.5%), fever (7.1%) and hematuria (7.1%).Conclusions: PCNL is safe and effective procedure for the managements of renal stones in children with acceptable morbidity.
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Introduction: Tetralogy of Fallot requiring transannular repair of the right ventricular outflow tract (RVOT) are exposed to free pulmonary insufficiency and hence inevitable right ventricular dysfunction. This study analyzes the function and structure of untreated autologous pericardium monocusp used to create a competent pulmonary valve. Materials and Methods: This is a retrospective analysis of 52 cases operated between December 2006 and December 2012. Untreated autologous pericardium was used for creating a competent pulmonary valve following a transannular patch. They are followed for functional and structural assessment of the pulmonary valve by echocardiography. Positron emission tomography (PET) with 18 fluorodeoxyglucose was performed in two cases for profiling the pulmonary valve. Results: Median age was 10.5 years (1–38). The follow-up was complete for 42 (80.76%) patients for 3 years and 25 (48.07%) patients for 5 years. The RVOT gradient was 42 mmHg (16–96) in the year of surgery, which reduced to 26 mmHg (10–58) and pulmonary insufficiency that was present in 8.3% of patients in 1st year was witnessed in 22.7% in the 5th year of follow-up. The monocusp patch was successful in creating a competent valve while maintaining its structure at 3 years; however, it became distorted and retracted at 5 years of follow-up. There was no calcification in any of the patients. PET-computed tomography confirmed the uptake of glucose by monocusp at 1 year of follow-up. Conclusion: The untreated autologous pericardium functioned well when it was used to create a competent pulmonary valve at short term and midterm. Although it changed in its structure; there was no calcification at 5 years of follow-up.
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We are presenting a very interesting X-ray image of the calcific aortic valve in a septuagenarian male patient who underwent successful aortic valve replacement.
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Background: The body height measurement plays an important role in personal and medico legal identification and has become invaluable aid to scientific research in Anatomy, especially anthropological anthropometry. This study is conducted to find the correlation between body height and foot length & knee height measurements in both the sexes and to determine accurate and best predictor of height from above two parameters using Correlation Coefficient. Methods: Asymptomatic, healthy 1000 subjects (500 males and 500 females), residents of Teerthanker Mahaveer University of cosmopolitan origin age over 18 years old were studied. Their body height, Foot lengths and knee height were measured and all the readings were subjected to Statistical Analysis using mean + standard deviation, Pearson’s correlation coefficients and linear regression analyses. Result: In present study, correlation coefficients (r) values between body height, foot lengths and knee height were found to be statistically significant and positive in both males, females and in combined data, with highest ‘r’ value of knee height followed by foot lengths. Regression equations for estimating body height were developed for each of these parameters by Linear Regression. Conclusion: The study suggests the Knee height to be the best body height indicator developed for estimation of body height according to gender including age as a predictor variable in order to reduce the inherent problem of sample specificity and enhance accuracy confidence in the estimation.
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Background & objectives: CYP4F2 and γ-glutamyl carboxylase (GGCX) have small but significant roles in the maintenance dose of coumarinic oral anticoagulants (COAs). CYP4F2 1347 G>A and GGCX 12970 C>G polymorphisms have been used in the pharmacogenetic dosing algorithms of warfarin for Caucasians and Chinese populations. India has a large population with multiple ethnic groups but there are no reports about the frequencies of these polymorphisms in north Indians. In the present study, we aimed to find out the allelic frequencies of CYP4F2 1347 G>A and GGCX 12970 C>G polymorphisms in a north Indian population and relate these to daily maintenance drug dose requirements of COA. Methods: CYP4F2 1347 G>A and GGCX 12970 C>G polymorphisms were genotyped by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) protocols and Taqman SNP discrimination assays in healthy volunteers (n=102) and patients (n=225) receiving acenocoumarol, an oral anticoagulant, after cardiac valve replacement surgery. Results: In healthy volunteers, the allele frequencies for CYP4F2 1347 G>A and GGCX 12970 C>G were 43.14 and 1.43 per cent, respectively. No significant differences in mean weight normalized doses of acenocoumarol were found for these CYP4F2 and GGCX genotypes. Binary logistic regression analysis revealed no significant association of any of the genotypes or alleles with the dosing phenotypes for both the SNPs. Interpretation & conclusions: We report distinct frequencies of CYP4F2 1347 G>A and GGCX 12970 C>G polymorphisms in north Indians but these polymorphisms did not have significant bearing on maintenance dose of acenocoumarol oral anticoagulant in cardiac valve replacement patients.
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BACKGROUND: Primary cardiac tumors are rare. There are only a few reports of such tumors from India. METHODS AND RESULTS: We report our experience with 34 patients with primary cardiac tumors operated on at our institute between December 1989 and October 2001. The study group comprised 16 males and 18 females with a mean age of 40.05 +/- 13.06 years (range 7-65 years). The predominant symptoms were breathlessness and congestive heart failure. In addition, 1 patient presented with peripheral embolism with impending limb ischemia that necessitated emergency embolectomy. Echocardiography was confirmatory in the diagnosis of all the benign tumors, whereas the malignant tumors were incidentally found during surgery. All the patients survived the operation. Complete resection of the tumor was possible only in benign tumors; however, malignant tumors were partly removed to relieve obstruction. All the excised benign tumors showed no recurrence on a mean follow-up of 54.78 +/- 31.30 months (range 3-108 months). Myxoma was found in 31 patients, left ventricular fibroma in 1, and leiomyosarcoma in 2. Both the patients with malignant tumors developed recurrence postoperatively, and succumbed to extensive distant metastases. CONCLUSIONS: The long-term outcome of surgery was excellent in patients with benign cardiac tumors. However, malignant tumors had an unchanged prognosis, although symptomatic relief was achieved.