Hypospadias with Intact Prepuce: A Spectrum of Anomalies and their Reconstruction.

Aims: The aim of the study was to perform a detailed analysis of the clinical characteristics of megameatus with intact prepuce (MIP) and to audit our results of reconstructive surgeries on MIP. Materials and Methods: Design: Retrospective analysis. Setting: Pediatric surgery department of tertiary level. Subjects, methods: Hospital records and pictures of MIP operated over a 9-year period. Age, size of penis, circumcised or not, shape of glans, external urethral meatus (EUM), urethral plate (UP), chordee, distal urethra, reconstructive surgery, and complications were analyzed. Postoperative result was objectively assessed by Hypospadias Objective Scoring Evaluation (HOSE). Results: Twelve of 254 hypospadias were MIP (incidence = 4.72%). The mean age at operation was 38.25 months (12-87 m). Patients sought circumcision or surgical correction of anomaly. Two patients were precircumcised. MIP was coronal 7, subcoronal 3, and glanular 2. Meatus was wide in 10 and normal in 2. Glans penis was wide in 9 and conical in 3. UP was wide (9), moderately wide (2), or narrow and shallow (1). In two cases of wide deep UP, distal septum was present. Distal urethra was nondilated in all but 1, which had megalourethra. Reconstructive surgery was Tubularized Urethral Plate Urethroplasty (7 cases) or classical Snodgrass (Tubularised incised plate urethroplasty (TIPU), with superimposed vascular dartos flap (5 cases). The megalourethra underwent partial excision and TIPU. Distal UP-septum was incised. Urethral injury (2 cases) and UP injury (1 case) were intraoperative complications. One postoperative complication (ventral glans necrosis) resulted. The mean follow-up period was 4.79 months (1-12 m). In the postoperative follow-up, 11 (92%) had HOSE score 14-16, whereas one had HOSE 13. Conclusion: Some hypospadias cases which have intact prepuce have no megameatus; hence, they cannot be termed MIP. All cases of hypospadias having intact prepuce can be covered by the umbrella term "Hypospadias with Intact Prepuce (HIP);" MIP is a large subgroup under HIP. HIP presents with a spectrum of anomalies of glans, EUM, and UP. Repair by tubularization of UP without or with midline incision gives excellent results.

Pleiotropic effects of Salacia reticulata and Simvastatin on oxidative stress and insulin resistance in a rat model.

BACKGROUND: The present study investigated the effects of Salacia reticulata and simvastatin on oxidative stress and insulin resistance in Sprague-Dawley (SD) rats. We compared the protective effect of a methanolic extract of Salacia reticulata (SR) with simvastatin (SVS) in rats fed a high-fat diet (HFD). METHODS AND RESULTS: Male Sprague-Dawley rats were divided into the following five different groups: control (C), C+SR, HFD, HFD+SR, and HFD+SVS. High-fat diet fed rats showed hyperglycemia, hyperinsulinemia, hyperleptinemia, dyslipidemia, and hypoadiponectinemia after 90 days. Treatment of high-fat diet fed rats with SR/SVS significantly (p < 0.05) reduced high-fat diet induced increases in plasma triglycerides, total cholesterol, very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and decreased high- density lipoprotein (HDL) accompanied by an increase in lipid peroxidation (LPO) and protein oxidation. In addition, a significant decrease in the activities of antioxidant enzymes and enzymes of the polyol pathway was observed in rats fed high-fat diet. SR was found to be more effective than SVS. Moreover, infiltration of inflammatory cells and fibrosis in the liver of high-fat diet fed rats by SR/SVS were also prevented. CONCLUSIONS: The present study confirms that SR/SVS may be a new and promising remedial approach because of its beneficial effects on the pathophysiological processes of obesity and related metabolic disorders.

Meconium Periorchitis is Amenable to Prompt Radiological Diagnosis.

Scrotal swellings in neonates are very common. A 25-day-old male child had right-sided firm, nontender scrotal swelling. Ultrasound scan (USS) diagnosed as meconium periorchitis (MPO). At 70 days of age, repeat USS and plain abdominoscrotal radiograph confirmed MPO, and surgery was avoided. Radiological diagnosis and management of MPO are discussed.

Preventive effect of Caralluma fimbriata against high-fat diet induced injury to heart by modulation of tissue lipids, oxidative stress and histological changes in Wistar rats.

OBJECTIVE: To investigate whether hydro-alcoholic extract of aerial parts of Caralluma fimbriata (CFE) could attenuate high-fat diet (HFD) induced cardiac damage. METHODS: Forty rats were divided into five groups: control (C), treated with CFE, treated with HFD, HFD treated with CFE, and HFD treated with metformin (Met). RESULTS: CFE treatment significantly (p < .001) attenuated HFD-induced increase in cardiac lipids such as total lipids, triglycerides, total cholesterol, and free fatty acids and decreased phospholipids accompanied by increasing in lipid peroxidation and protein oxidation. Furthermore, significant reduction in the activities of antioxidant enzymes, creatine kinase and aldose reductase and sorbitol dehydrogenase was also observed in HFD fed rats. These changes were alleviated by CFE. Moreover, the histopathological observations of heart are also in agreement with the biochemical findings. CONCLUSION: The present study confirmed that CFE could be used as adjuvant therapy for preventing or managing high fat diet induced cardiac damage.

Hemoperitoneum Due to Ruptured Botryoid Sarcoma of the Uterus in Young Girl.

Five-year-old girl presented with lower abdominal pain, pelvi-abdominal mass, and generalized abdominal tenderness. Ultrasound and computed tomography scans diagnosed heterogeneous pelvi-abdominal soft-tissue mass and a large amount of free peritoneal fluid. Laparotomy revealed hemoperitoneum and ruptured tumor at the posterior uterine wall. Histopathology report was botryoid rhabdomyosarcoma (BRMS). This case is unique due to ruptured BRMS of the uterus in early childhood, with no vaginal bleeding.

Preventive effect of Caralluma fimbriata vs. Metformin against high-fat diet-induced alterations in lipid metabolism in Wistar rats.

The objective of the present study was to investigate the preventive effects of hydro-alcoholic extract of Caralluma fimbriata (CFE) and Metformin (Met) against high-fat diet (HF-diet) induced alterations in lipid metabolism in Wistar rats. The experimental animals were divided into five groups, two of which were fed with chow diet and the other three with HF- (60%) diet. CFE (200mg/kg body weight/day) was administered through oral route to each group of chow-fed rats, HF-fed rats and Met (20mg/kg body weight/day) to one of the HF-diet fed groups. At the end of 90days of experimental period, hypercholestermia, hypertriglycerdemia, with decreased HDL-cholesterol and increased LDL, VLDL-cholesterol and atherogenic index and elevated levels of serum and hepatic transaminases and hepatic lipids (p<0.05) and alterations in the activities of enzymes of lipid metabolism, and the liver showed mild to severe distortion of the normal architecture as well as prominence and widening of the liver sinusoids as observed in HF-fed rats, were prevented by CFE/Met treatment. The results showed that CFE/Met supplementation ameliorated significantly the disturbance in serum and hepatic transaminases, plasma and hepatic lipid profile and lipid metabolism under HF-fed conditions. It can be concluded from these results that CFE might be valuable in reducing the alterations related to lipid metabolism under high calorie diet consumption.

Protective effect of Caralluma fimbriata against high-fat diet induced testicular oxidative stress in rats.

High-fat diet (HFD) promotes the oxidative stress formation, which in turn has hazardous effects on reproductive system and fertility. The objective of this study was to evaluate the protective effect of Caralluma fimbriata on high-fat diet-induced oxidative stress in the testis of rat. Male Wistar rats were randomly divided into five groups: Control (C), Control treated with CFE (C+ CFE), High fat diet fed (HFD), High fat diet fed treated with CFE (HFD+CFE) and High fat diet fed treated with Metformin (HFD+Met). CFE was orally administered (200mg/kg body weight) for 90days to groups-C+CFE and HFD+CFE rats. The effects of HF-diet on the reproductive organs were determined by measuring relative and absolute testes and epididymal fat pads weights. Regarding testes antioxidant status, high-fat fed rats showed higher levels of lipid peroxidation, protein oxidation, polyol pathway enzymes and lower GSH levels and lower activities of antioxidants, while CFE treatment prevented all these observed abnormalities. The present study clearly indicates that CFE offers a significant protection against HF-diet induced testicular oxidative stress in rats.

Renoprotective effect of Caralluma fimbriata against high-fat diet-induced oxidative stress in Wistar rats.

The current study was designed to evaluate the renoprotective effect of hydro-alcoholic extract of Caralluma fimbriata (CFE) against high-fat diet-induced oxidative stress in Wistar rats. Male Wistar rats were randomly divided into five groups: control (C), control treated with CFE (C + CFE), high-fat diet fed (HFD), high-fat diet fed treated with CFE (HFD + CFE), and high-fat diet fed treated with metformin (HFD + metformin). CFE was orally administered (200 mg/kg body weight) to Groups C + CFE and HFD + CFE rats for 90 days. Renal functional markers such as, urea, uric acid, and creatinine levels in plasma were quantified during the experimental period. At the end of the experimental period, activities of transaminases and oxidative stress markers, i.e., reduced glutathione (GSH), lipid peroxidation, protein oxidation, and activities of antioxidant enzymes were assayed in renal tissue. Coadministration of CFE along with HF-diet in Group HFD + CFE prevented the rise in the levels of plasma urea, uric acid, and creatinine, and elevated activities of renal transaminases with decreased protein content of Group HFD (p < 0.05). Establishment of oxidative stress in Group HFD, as evident from elevated lipid peroxidation, protein oxidation levels with depleted levels of GSH, and decreased activities of GSH dependent and independent antioxidant enzymes, was prevented in Groups HFD + CFE and HFD + metformin rats. Further, there were no deviations in the studied parameters but there was improved antioxidant status of Group C + CFE from Group C which revealed the nontoxic nature of CFE even under chronic treatment. Thus, CFE treatment effectively alleviated the HF-diet induced renal damage. Hence, this plant could be used as an adjuvant therapy for the prevention and/or management of HF-diet induced renal damage.

In Vitro Evaluation of the Antimicrobial Efficacy of Four Endodontic Biomaterials against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus.

Root canal sealers that possess good antimicrobial property can prevent residual and recurrent infection and contribute to successful endodontic therapy. This study evaluated the antimicrobial activity of four endodontic sealers, AH Plus, Tubliseal EWT, EndoRez, and iRoot SP, against three different microorganisms, E. faecalis, C. albicans, and S. aureus, by direct contact test. 10 µL microbial suspensions were allowed to directly contact the four endodontic sealers for 1 hr at 37°C. Subsequently microbial growth was measured spectrophotometrically every 30 min for 18 hours. The microbial suspensions were simultaneously tested to determine the antimicrobial effect of components which are capable of diffusing into the medium. The results revealed that AH Plus and iRootSP had significantly higher antimicrobial activity against E. faecalis. AH Plus and Tubliseal EWT showed significantly higher antimicrobial activity against C. albicans and S. aureus compared to iRoot SP and EndoRez. EndoRez showed the least antimicrobial activity against all the three microorganisms. Inhibition of microbial growth is related to the direct contact of microorganisms with the sealers. In conclusion AH Plus had significantly higher antimicrobial activity against E. faecalis, C. albicans, and S. aureus.