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REVIEW ARTICLE
Vacuum erectile device for penile rehabilitation
Haocheng Lin, Grace Wang, Run Wang
July-September 2014, 1(1):4-10
DOI:10.4103/2225-1243.137541  
The vacuum erectile device (VED) uses negative pressure to increase blood inflow and oxygen into the corpora cavernosum, with a ring at the base of the penis to maintain the erection for intercourse or without a ring for penile rehabilitation. As the limitation of phosphodiesterase 5 inhibitors (PDE5I) showed in the treatment of refractory erectile dysfunction (ED), the use of VED resurged and is becoming the first-line therapy in treatment of ED after radical prostatectomy. Currently, the combination therapy of VED and PDE5I and of VED and intracavernous injection are advocated. Furthermore, there has been increasing interest in the use of VED to preserve penile length in inflatable penile prosthesis preoperation procedure and Peyronie's disease. Hereby, we reviewed the underlying mechanisms, the status of VED in penile rehabilitation, the combination therapy and the expanded use of VED.
  9,735 442 -
ORIGINAL ARTICLES
Ultrasound spectrum of tubular ectasia of rete testis and epididymis: Emphasis on early detection
Aniruddha R Kulkarni, Mohammed Ashfaque Tinmaswala, Shubhangi V Shetkar
January-March 2017, 4(1):14-20
DOI:10.4103/2394-2916.201280  
Background and Objectives: Tubular ectasia is a rare, pathologically benign condition which initially may present as tiny cyst. Knowledge of typical ultrasound features of this condition helps to differentiate it from other malignant lesions of testis. This study was conducted to find out ultrasound spectrum of tubular ectasia of rete testis and epididymis. Methods: Patients undergoing scrotal ultrasound and doppler for various indications including scrotal pain, infertility, postvasectomy and prior to recanalisation of vas were studied. The history, clinical examination, semen analysis and ultrasound features were analyzed. Our emphasis was on early detection of this rare but benign entity involving testis and epididymis. Results: Scrotal ultrasound with colour doppler in these patients revealed the abnormalities ranging from early changes like specked appearance and tiny cysts to more severe forms involving rete testis and epididymis. Associated abnormalities like epididymal cyst, hydrocele and spermatocele were also found in addition to tubular ectasia in some cases. Conclusion: Tubular ectasia is a pathologically benign condition which can be reliably diagnosed on ultrasound and colour doppler. Familiarity with the ultrasound and doppler features of tubular ectasia will definitely help in early diagnosis which in turn will help in reducing patients' anxiety and prevent unnecessary interventions.
  8,841 432 -
CASE REPORTS
Chronic Kidney Disease Caused by Hypothyroidism
Zhenhua Li, Yi Wang
July-September 2015, 2(3):93-95
DOI:10.4103/2225-1243.161438  
Primary hypothyroidism refers to a systemic hypometabolic status due to hypothyroxinemia or thyroid hormone resistance caused by pathologic changes to the thyroid gland. The main role of thyroid hormone is to promote energy metabolism and facilitate growth and development processes within the body. In a hypothyroidism state caused by thyroid hormone deficiency, the body's thermogenic effect is down-regulated and metabolisms of protein, sugar, and fat were slowed down, which might further lead to cardiovascular disease, hyperlipidemia, myocardial damage and myxedema, as well as other changes. Hypothyroidism tends to be neglected or misdiagnosed due to its trivial and nonspecific clinical manifestations, and a combined renal dysfunction is rarely reported. Herein a case of kidney dysfunction caused by hypothyroidism is reported and relevant literature was reviewed.
  7,573 271 -
REVIEW ARTICLES
Myoglobinuria and Acute Kidney Injury
Snehamayee Nayak, Atul Jindal
April-June 2015, 2(2):50-54
DOI:10.4103/2225-1243.155775  
Myoglobin is a heme protein present in muscle tissues and responsible for binding and delivery of oxygen in the muscle cells for oxidative metabolism. Whenever muscle tissue is injured, that is, rhabdomyolysis occurs free myoglobin enters into circulation along with other enzymes and electrolytes and myoglobinuria occurs when the renal threshold is crossed. There are many causes of rhabdomyolysis including physical damage, infective, inflammatory, toxic, and metabolic problems. Clinically, myoglobinuria presents as muscle pain, weakness, cola colored urine, and laboratory diagnosis is done by elevated serum creatine kinase, urine dipstick positive for blood without RBC in microscopy examination. These myoglobin molecules can cause renal injury by renal vasoconstriction, proximal tubular necrosis, and distal tubular obstruction. Early anticipation of myoglobinuria and aggressive fluid resuscitation during the initial stage of injury is the mainstay of management of myoglobinuric acute kidney injury (AKI). There is lesser role of forced alkaline diuresis and mannitol than diuresis by normal crystalloid solution in myoglobinuric AKI. Renal replacement therapy should be considered in cases with life-threatening dyselectrolytemia and acidosis.
  5,733 425 4
CASE REPORTS
Septic Arthritis of the Knee Due to Escherichia Coli Secondary to Acute Pyelonephritis
Akihito Tanaka, Yuichi Ito
April-June 2015, 2(2):64-66
DOI:10.4103/2225-1243.155778  
We report a 67-year-old woman with osteoarthritis (OA) of knees. She also had past histories such as dyslipidemia and hypertension. She was sometimes treated by hyaluronan-injection into the knees for OA at the nearby clinic. She was admitted to our hospital because of acute pyelonephritis in July 2014. We treated her successfully with ceftriaxone first empirically and de-escalated to cefazolin along with the results of urinary and blood cultures. Urinary and blood cultures revealed Escherichia coli. She recovered from pyelonephritis, however, began to complain pain and swelling of the right knee. Culture of the right knee-joint fluid also revealed E. coli. We diagnosed septic arthritis of the right knee and performed arthroscopic lavage, followed by continuous washout with saline for 7 days. She recovered from septic arthritis of the right knee and discharged from our hospital. Although rare, it is important that pyelonephritis-derived sepsis cause septic arthritis of the knee.
  5,801 167 -
REVIEW ARTICLES
Recent Advances in Pharmacotherapy for Peyronie's Disease
Yang Luan, Jihong Liu
April-June 2016, 3(2):53-59
DOI:10.4103/2394-2916.181219  
Peyronie's disease (PD) is an acquired fibrotic disease of the penile tunica albuginea accompanied by penile pain, curvature, erectile dysfunction, and psychosocial problems. Recent evidence suggests an increasing prevalence of PD with current uncertainty of its etiology and pathophysiology. According to the natural history of PD, the disease can be divided into acute phase and fibrotic phase that greatly determines the treatment plan. Oral, intralesional medication, and topical therapy are suitable for acute phase while surgical therapy is suggested only in fibrotic phase with the formation of stable plaques. Although a number of pharmacologic agents have been evaluated in preclinical and clinical studies, a few of them can be used in the clinic with satisfactory outcome. Recent studies showed promising results in improving symptoms and limiting disease progression, especially the only Food and Drug Administration-approved collagenase Clostridium histolyticum as well as some multimodal therapies. In this study, we reviewed currently available medications and focused on recent advances in PD pharmacotherapy. However, further high-quality studies are much needed to clarify the pathogenesis of PD and, more importantly, to find out effective and safe medicines for PD treatment.
  4,878 167 -
Scientific medicine in integrative treatment of erectile dysfunction
Jaroslava Wendlová
January-March 2015, 2(1):5-18
DOI:10.4103/2225-1243.149992  
Due to the increase in erectile dysfunction (ED) and infertility in world population, there is growing interest in the integrative treatment of these diseases. Therefore, it is raising a market with non-prescription natural supplements. Especially in menu of internet, online shops come increasingly to light new natural over the counter products. Recent sale and use of medicinal plants and their extracts in the treatment of ED are according to the declaration of the producers first of all on a number of the thousand-year-old traditions in some nations, based on the efficacy and safety of these plants, verified in the long-time healing practice. The aim of this article was to make an extensive review of the scientific and professional medical literature and to find out which medicinal plants, minerals and other active substances, sold in the natural products for ED, were evaluated in relevant clinical trials as statistically significant in their efficacy and safety. The review of the literature shows that some marketed medicinal plants and active substances lack clinical studies, the results of some clinical studies related to the same medicinal plant are controversial and some bring significantly positive effects, but their number is minimal (maximum two to five clinical studies). The future is therefore open to starting the number of new clinical trials testing the medicinal plants for the treatment of ED with possible inclusion of some of these plants in evidence-based medicine, if confirming their efficacy and safety.
  4,177 234 -
Reflections on the Medical History of the Kidney: From Alcmaeon of Croton to Richard Bright - Standing on the Shoulders of Giants
Donald E Greydanus, Musunkumuki Kadochi
October-December 2016, 3(4):101-108
DOI:10.4103/2394-2916.193496  
Although renal disease has been present for over 200 millennia of Homo sapiens' existence, knowledge of the causes and management of these disorders has only emerged during the last 4000 years. Brilliant insights into human disease probably emerged from time to time over the long period of human existence, but observations could only be advanced after writing began in 3200 BC. Humans could then make observations, record these thoughts, and have others in their present and future critique them leading to improvement in this information. This discussion selectively considers some of the medical giants who led the way to clinical nephrology of the 21st century. It reflects on who taught us basic principles of renal disease that led to our current knowledge. Attention is given to the ancient Egyptians, Ancient Greeks, Galen of Pergamon, the Byzantine Greeks of the 5th-9th centuries, the Arab/Persian Physicians of the 9th-12th centuries, Moses Maimonides of the 12th century, selective Renaissance Physicians, and the father of modern nephrology - Richard Bright MD. This reflection celebrates au courant renal sagacity by celebrating the past clinicians who led the way from their eras to ours.
  2,281 1,981 -
EDITORIAL
Shockwave therapy for erectile dysfunction: Is it really effective?
Yu Xi Terence Law, King Chien Joe Lee
July-September 2017, 4(3):71-72
DOI:10.4103/jina.jina_15_17  
  3,993 219 -
REVIEW ARTICLES
Prevalence of Human Papillomavirus Infection in the Female Genital Tract of Kidney Transplant Recipients: A Systematic Review
Cleine Aglacy Nunes Miranda, Paulo Henrique Lima, Ana Katherine Gonçalves, Maria Da Conceição de Mesquita Cornetta, Ana Karla Monteiro Santana de Oliveira Freitas, Ricardo Ney Oliveira Cobucci, Janaina Cristiana de Oliveira Crispim
October-December 2015, 2(4):101-106
DOI:10.4103/2225-1243.168523  
Estimation of the prevalence of high-risk human papillomavirus (HR-HPV) genotypes and cervical intraepithelial neoplasia (CIN) in female renal transplant recipients (RTRs) is important for formulating strategies for the prevention and screening of cervical cancer in this susceptible group. A systematic review of cohort studies was conducted to evaluate the prevalence of HR-HPV cervical infection and CIN in female kidney graft recipients in comparison to healthy controls. This study adhered to the meta-analysis of observational studies in epidemiology guidelines. Studies had to meet the following criteria: (1) Cohort studies of female RTRs that assessed results of cervical cytology and/or HPV prevalence, (2) studies including adult and nonpregnant subjects, (3) the description of the study's methodological and statistical methods is provided, and (4) the prevalence of HPV was clearly stated. The prevalence of HPV infection and CIN reported in the assessed studies ranged, respectively, from 4% to 45% and 0% to more than 48% in female RTR groups, while in the control groups the prevalence ranged from 17.5% to 38% and 0% to 13%. There are relatively few publications dealing with the prevalence of CIN and HPV infection in the population of transplant recipients, and the current available studies show important methodological differences. Therefore, new observational studies with larger numbers of transplanted women, proper design and control of these biases are needed to see if, among this population, the prevalence of HR-HPV infection and CIN is greater.
  1,341 2,580 -
Diagnosis and Treatment of Nephrotic Syndrome in the Elderly
Min-xia Li, Guang-yan Cai
October-December 2015, 2(4):123-127
DOI:10.4103/2225-1243.168530  
Nephrotic syndrome is a common clinical type of glomerular diseases in the elderly and has its own characteristics in the pathological types, clinical manifestations, and diagnoses. Renal biopsy is an important diagnostic method for elderly patients with nephrotic syndrome. Membranous nephropathy is the most common primary pathology while amyloidosis and diabetic nephropathy are common secondary causes. Individualized treatments should be performed according to ages and physical characteristics of the elderly patients.
  3,417 474 -
ORIGINAL ARTICLES
A Study on the Drug Utilization Pattern in Patients with Chronic Kidney Disease with Emphasis on Antibiotics
Soumya Santra, Divya Agrawal, Sanjay Kumar, Sudhanshu Sekhar Mishra
July-September 2015, 2(3):85-89
DOI:10.4103/2225-1243.161435  
Objective: To study and describe the utilization pattern of various classes of drugs including antibiotics in patients with chronic kidney disease (CKD). Materials and Methods: A total of 185 CKD patients were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study that was conducted over a period of 6 months in Nephrology Department of a tertiary care teaching hospital. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Results: Mean age of CKD patients was 45.81 ± 11.16 with male predominance (58%). CKD Stage III comprised of the maximum number (28%) of patients. Polypharmacy was executed in 83% of these patients. Hypertension (95%), diabetes (87%), and anemia (86%) are the most common co-morbidities. The five most frequently prescribed drugs were diuretics (100%), anti-ulcer agents like proton pump inhibitors and H 2 blockers (98%), anti-hypertensives (95%), vitamins and minerals supplements including calcium (92%), and hematinics (85%). Infectious diseases like respiratory tract infection (37%) and urinary tract infection (34%) had shown to have a high prevalence in CKD patients. Cefoperazone, metronidazole, piperacillin + tazobactam were the most prescribed parenteral antibiotics. Azithromycin and levofloxacin were the extensively used oral antibiotics. Conclusion: This study demonstrates the variability of drug utilization in CKD patients. Drug utilization studies on a regular basis give a framework to pharmaceutical companies and healthcare providers and help to build management strategies. However, the right choice of drugs and inappropriate doses will reduce the incidence of nephrotoxicity and ultimately result better clinical outcomes. Managing infections and prescribing antibiotics in CKD are crucial and hence claim rationalization of the use of antibiotics to improve the quality of life of CKD patients.
  3,252 460 -
REVIEW ARTICLE
Prevention and Treatment of Diabetic Nephropathy Using Traditional Chinese Medicine
Xia Chen, Aili Cao, Li Wang, Peihao Yin, Xuemei Zhang, Wen Peng
October-December 2014, 1(2):53-57
DOI:10.4103/2225-1243.143374  
Diabetic nephropathy (DN) is a leading cause of end-stage renal disease worldwide. The mainstay of DN has been management of hyperglycemia, blood pressure and proteinuria using hypoglycemic agents, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Application of traditional Chinese medicine (TCM) for DN has received increasing attention due to its wide availability, low side-effects, proven therapeutic mechanisms and benefits. In this paper, we mainly focus on the recent studies of TCM including Tongxinluo, Chaihuang-Yishen granule, Shenyan Kangfu tablets, Danggui Buxue Tang, Gordon Euryale Seed, Cherokee Rose Fruit and Bawei Dihuang wan, and the effective components of TCM, including Astragalus and Astragalus polysaccharide. The aim of this study is to review the protection and treatment effect of TCM for treating DN in type 1 and type 2 diabetes mellitus. Meanwhile, the possible mechanisms of major compounds and active crude drugs are also summarized.
  2,649 728 1
MINI REVIEW
Elevated uric acid levels as another cause of erectile dysfunction: Hypothesis and rationale?
Baris Afsar
July-September 2014, 1(1):11-13
DOI:10.4103/2225-1243.137543  
Elevated uric acid (UA) levels has been shown to be associated with cardiovascular disease such as hypertension, coronary heart disease, heart failure, renal failure, peripheral vascular disease, metabolic syndrome, and stroke. In addition, in recent years various novel pathological entities such as endothelial dysfunction, oxidative stress, inflammation, activation of the renin angiotensin system (RAS) has been found to be associated with increased UA levels. Erectile dysfunction (ED) on the other hand has also been associated with cardiovascular risk. Besides, similar mechanisms such as endothelial dysfunction, oxidative stress and RAS have been found to be related with ED. Thus, the current hypothesis tried to explain why UA may be associated with ED.
  3,147 204 -
REVIEW ARTICLE
Association of lipid abnormalities and oxidative stress with diabetic nephropathy
Kamal Kachhawa, Divya Agrawal, Bandana Rath, Sanjay Kumar
January-March 2017, 4(1):3-9
DOI:10.4103/jina.jina_1_17  
Chronic kidney disease (CKD) is characterized by progressive loss of renal function. Although the burden of CKD in India cannot be assessed accurately, its approximate prevalence is believed to be 800 per million populations (pmp), and the incidence of end-stage renal disease (ESRD) is 150–200 pmp. Diabetic nephropathy is a leading cause of ESRD worldwide. Another cause of ESRD is dyslipidemia, which is one of the most common quantitative lipid abnormalities in patients with CKD. In diabetes, the total cholesterol and triglyceride levels rise as the albumin excretion rate increases, leading to renal injury. Oxidative stress generated by hyperglycemia increases reactive oxygen species production, which causes cellular dysfunction and damage, and ultimately results in diabetic micro- and macro-vascular complications. Therefore, lipids may represent a useful clinical tool for not only identifying patients at a high risk of developing CVD but also assessing the development and progression of renal disease. In this review, we summarize the effects of lipid abnormalities and oxidative stress in patients with diabetes and nephropathy.
  3,010 314 2
EDITORIAL
Glomerular Capillary Endothelial Injury in Diabetic Nephropathy
Dingkun Gui, Niansong Wang
October-December 2014, 1(2):51-52
DOI:10.4103/2225-1243.143371  
  1,113 2,093 -
REVIEW ARTICLES
Association of Male Infertility to Metabolic Syndrome and Other Related Disorders
Sanjay Kumar, Divya Agrawal, Kunal Sharma, Trupti Rekha Swain
October-December 2015, 2(4):107-116
DOI:10.4103/2225-1243.168524  
Metabolic syndrome is a common global problem. This condition is also multifaceted and potential precursor to significant disturbance of numerous physiologic processes. The interconnected complexities of this disorder may varies from, life threatening risk of cardiovascular atherosclerotic diseases, type 2 diabetes, and hypertension to many of other metabolic diseases like male or female infertility. This review article cogitate the literature regarding metabolic syndrome and male reproductive health. The association between abdominal obesity, insulin resistance, systemic hypertension, and dyslipidemia are each examined with regard to their interconnected deleterious effects on male fertility. At the conclusion of this manuscript, we propose a new metabolic syndrome with male infertility paradigm. Supplementary acquisition particularly addressing the components of metabolic syndrome and their impact on male reproduction will enhance our understanding of the underlying pathophysiology. These studies may also help elucidate the role for therapeutic intervention.
  2,522 664 1
REVIEW ARTICLE
Renal Tubulointerstitial Fibrosis: A Review in Animal Models
Jie Zhao, Li Wang, Aili Cao, Minqian Jiang, Xia Chen, Wen Peng
July-September 2015, 2(3):75-80
DOI:10.4103/2225-1243.161428  
Deterioration of renal function is closely related to renal interstitial fibrosis (RIF). With animal models, we can simulate the pathological changes and progression of disease. Various animal models of RIF are pivotal for clinical treatment and investigation of new drugs. Reviewed here are methods of establishment and mechanism of commonly used animal models of RIF to help researchers select the optimal animal model for different research purposes.
  2,682 473 -
ORIGINAL ARTICLE
Etiological Spectrum of Chronic Kidney Disease in Young: A Single Center Study from South India
Putta Rajasekar, Vaddera Sameeraja, Beldari Poornima
April-June 2015, 2(2):55-60
DOI:10.4103/2225-1243.155776  
Background and objectives: Chronic kidney disease (CKD) is an important, chronic, noncommunicable disease epidemic that affects the world. Lack of registries precludes an accurate estimation of the number of patients with CKD. Only a few studies are done in our country to assess etiology of CKD in young patients. This study was aimed to assess the etiology of CKD in young patients. Materials and Methods: Data were collected from 50 patients of CKD between 15 and 40 years age who presented to Government General Hospital, Kurnool from July 2012 to June 2013. They were clinically evaluated and underwent relevant investigations including renal biopsy in indicated cases. Results: Of the 50 patients studied, there was an overall male preponderance over all age groups with a mean age of 27.6 ± 4.9 years. Small kidneys were seen in 70% of patients. 92% of patients had proteinuria. Most common symptoms of presentation were related to gastrointestinal disturbances, breathlessness, easy fatigability, and urinary disturbances. Pallor, pedal edema, and facial puffiness were major clinical features. Majority (62%) had CKD of unknown etiology. In this unknown etiology patients, majority were found to have glomerular disease (42%) based on clinical presentation and other supporting investigations. 92% presented in stage IV or stage V CKD. Histopathologically etiology was proven among 19 patients (38%) with renal biopsy. Conclusion: It is concluded that male patients in the third and fourth decades were in the majority requiring medical care. Chronic Glomerulonephritis of unknown causes constitutes a major etiology among the young presenting in late stages of CKD.
  2,924 226 -
ORIGINAL ARTICLES
The Role of Varicocelectomy on Patients with Premature Ejaculation and Varicoceles
Mohammed Abu El-Hamd, Hosam Farouk Abdel Hameed
October-December 2016, 3(4):121-125
DOI:10.4103/2394-2916.193515  
Objectives: This study aimed to assess the role of varicocelectomy in the improvement of premature ejaculation (PE) in patients with clinical varicoceles and PE. Materials and Methods: In a prospective clinical study, it conducted on 85 male patients with clinical varicoceles and PE. Those patients were selected from whom attending the Outpatient Clinics of Andrology and General Surgery at Sohag University Hospital, Upper Egypt, between February 2015 and May 2016. All patients were subjected to preliminary assessment included a detailed medical and sexual history and general and genital examination. Patients were treated with open bilateral subinguinal varicocelectomy under spinal anesthesia. All patients were evaluated before and 6 months after the varicocelectomy by PE diagnostic tool (PEDT). The intravaginal ejaculatory latency times (IELTs) per minute and overall sexual satisfaction scores were evaluated before and 6 months after varicocelectomy. All patients were asked to indicate their sexual satisfaction on a scale of 0-5, with 0 being extremely dissatisfied and 5 being extremely satisfied. Results: The mean scores of the five questions of the PEDT measuring ejaculation control, frequency of inability of ejaculation control, ejaculation with minimal stimulation, feel of distress, and interpersonal difficulty owing to PE had statistically significant improvements at 6 months after varicocelectomy. The mean IELTs per minute and overall sexual satisfaction scores were significantly improved at 6 months after varicocelectomy. Conclusions: The study concluded that varicocelectomy improve PE in patients with bilateral clinical varicoceles and PE. Further prospective, controlled studies are needed to provide further characterization of this potential relationship.
  2,957 141 -
REVIEW ARTICLES
Genetic Factors for End-Stage Renal Disease
Guisen Li
April-June 2015, 2(2):46-49
DOI:10.4103/2225-1243.155774  
Genetic factor plays an important role in the progression of chronic kidney diseases and in the development of end-stage renal disease (ESRD). Present studies on ESRD, estimated glomerular filtration rate, and renal fibrosis have demonstrated a great number of genetic variants that are associated with the susceptibility to ESRD by different genetic study strategies. These results may provide novel insights about the development and prevention of ESRD.
  2,688 211 -
EDITORIAL
Crossing Renal Vessel Causing Ureteropelvic Junction Obstruction in Children
Ahmet Guven
April-June 2016, 3(2):31-32
DOI:10.4103/2394-2916.181215  
  2,656 199 1
CASE REPORTS
Vocal Cord Palsy as a Complication of Central Vein Catheterization: A Case Report
Manjunath Kulkarni, Prashanth Kadri, Kuldeep Moras, Nikhil D' Souza, Maria Bethsaida
April-June 2015, 2(2):69-70
DOI:10.4103/2225-1243.155781  
We report a case of a 55-year-old female diabetic patient admitted with uremia. An attempt for insertion of a temporary dialysis into right internal jugular vein was not successful. Next day, the patient developed hoarseness of voice. Indirect laryngoscopy showed that right vocal cord was in paramedian position suggestive of palsy due to injury to recurrent laryngeal nerve. Vocal cord palsy, as a complication of central vein catheterization, is very rare.
  2,637 142 -
ORIGINAL ARTICLES
Clinical and bacteriological profile of Uti patients attending a north Indian tertiary care center
Ruhi Khan, Quaiser Saif, Khan Fatima, Rizvi Meher, Haque Faizul Shahzad, Khan Salamat Anwar
January-March 2015, 2(1):29-34
DOI:10.4103/2225-1243.150009  
Objective: Urinary tract infection (UTI) is a common cause of morbidity in patients attending our hospital. Recently UTI has become more complicated and difficult to treat because of appearance of pathogens resistant to the commonly used antimicrobial agents. The main aim of the study was to determine the causative agents and antibiotic susceptibility pattern of UTI patients attending our hospital. Materials and methods: A prospective cross sectional study was conducted in asymptomatic and symptomatic UTI patients attending medicine and nephrology clinics of Jawaharlal Nehru Medical College Hospital, Aligarh from June 2012 to July 2014. A total of 1843 patients were investigated for urinary tract infection. Clean catch mid-stream urine specimens collected were subjected to urine culture and sensitivity tests. Results: Significant bacteriuria was detected in 19.3% and 55.4% of asymptomatic and symptomatic patients, respectively. The overall prevalence of significant bacteriuria in both groups was 33.4% with female sex, diabetes, obstructive uropathy, previous instrumentation and chronic kidney disease being the major risk factors. The most common pathogens isolated were Escherichia coli (52.4%) followed by Klebsiella pneumoniae (12.3%), Citrobacter spp (9.1%), Enterococcus (6.9%), Proteus spp (5.3%), Coagulase negative staphylococcus (5.3%) and Staph Aureus(4.0%). Most susceptible antibiotic was Amikacin, Cefoperazone-sulbactum, Piperacillin-tazobactum and Nitrofurantoin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin (78.3%), Cefoperazone-sulbactum 72.8%, Piperacillin-tazobactum (70.5%), Gentamicin (69.3%) and Nitrofurantoin (67.3%). Conclusion: This study highlights the common pathogens causing UTI in our area and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports.
  2,410 252 -
CASE REPORTS
A Rare Complication of Artificial Urinary Sphincter: Deep Venous Thrombosis Due to Compression of Femoral Vein by Pressure Regulating Balloon
Ross E Anderson, Jeremy B Myers, James M Hotaling, William O Brant
April-June 2015, 2(2):61-63
DOI:10.4103/2225-1243.155777  
The placement of artificial urinary sphincters (AUSs) is a common procedure for stress incontinence following treatment for prostate cancer. Complications are relatively rare, and the most common reasons for device removal and revision are cuff erosion, infection, and mechanical failure. We present a case of a 66-year-old male with a history of radiation therapy for prostate cancer that developed a deep venous thrombosis (DVT) and pulmonary embolism (PE) following his second AUS due to compression by a pressure regulating balloon (PRB). Compression of the femoral vein was not originally diagnosed as the cause for DVT on initial hospitalization, and there was an additional hospitalization due to worsening symptoms prior to identification of PRB compression. This is the first published case of migrating PRB causing femoral DVT and PE following the placement of a second AUS in an irradiated tissue field, and one of two published cases of DVT due to PRB compression.
  2,390 100 2