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Biomedical subjects

Amlesh Seth

Publications and source records attributed to Amlesh Seth.

25 records · Page 2Linked to original sources
PubMed2002

Autocystectomy following extensive genitourinary tuberculosis: presentation and management.

Genitourinary tuberculosis is an important cause of morbidity in developing and developed countries. We describe a case of extensive genitourinary tuberculosis in which there was complete destruction of the right kidney, stricture of the entire left ureter and an autocystectomized bladder. He presented in azotemia with urinary incontinence and was managed by right nephroureterectomy, ileal replacement of left ureter and ileal neobladder after a preliminary nephrostomy and antituberculous chemotherapy.

Adult↗
PubMedDate not supplied

Cowper's syringocele in an adult.

Cowper's syringocele is cystic dilatation of the excretory bulbourethral gland duct. It is an uncommon condition and is usually reported in children. There are only ten previous case reports of late presentation in adulthood to the best of our knowledge. We present the imaging findings of such a case manifesting at 30 years of age.

Adult↗
PubMedDate not supplied

Germ cell tumours of the testis: clinical features, treatment outcome and prognostic factors.

BACKGROUND: The prognosis of patients with germ cell tumours of the testis has Improved over the past two decades following cisplatinum-based chemotherapy. Currently, staging and risk assessment of the disease is crucial in order to provide curative therapy for patients with poor risk features and not over-treat good risk patients. METHODS: We reviewed the case records of 71 men diagnosed to have germ cell tumours between January 1993 and October 1999. Their clinical characteristics, staging, treatment outcome and prognostic factors for response and survival were analysed. RESULTS: The median age of the patients was 30 years (range: 3-65 years); 69% were in the third and fourth decades. Sixty-one patients (86%) had a primary testicular tumour while in 10 (14%) the tumour was extragonadal. Histopathologically, 53 patients (75%) had non-seminomatous germ cell tumours and 15 (21%) had a seminoma. Twenty-seven patients (62%) had evidence of metastatic disease at the time of diagnosis. On prognostication, non-seminomatous germ cell tumour patients could be divded into good, intemediate and poor prognostic groups comprising 41%, 17% and 40% of patients, respectively. All patients with a seminoma were in the good prognostic subgroup. Fifty-eight patients were evaluable for response. Overall, 91% of patients responded: complete response 71% and partial response 20%. Complete response rates were signiflcantly higher for the good risk (95%) compared to the intermediate (49%) and poor risk (47%) categories (p< 0.003). At a median follow up of 26 months, the 2-year overall and progression-free survival for all patients was 70% and 57%, respectively. The predictors for decreased overall and progression-free survival were age >35 years, presence of poor risk features and mediastinal primary disease. CONCLUSION: The outcome for germ cell tumours in men with good risk is excellent. A protocol consisting of bleomycin, etoposide and cisplatin is effective. Tailoring of chemotherapy In good risk patients to minimize toxicity and Improving results in poor risk patients are areas that need further work.

Adolescent↗
PubMedDate not supplied

Massive pleural effusion without bony involvement: an unusual presentation of advanced carcinoma prostate.

As noted under the natural history, the bone of axial skeleton and the ileopelvic lymphnodes specially the obturator groups are the commonest sites of metastasis spread of cancer prostate. Visceral metastasis in the absence of the above is extremely rare. We present a 50-year-male patient of cancer prostate with pleural metastases, pleural effusion and lung collapse on right side. Bone scan was essentially normal. Bilateral orchiectomy was done. Pleural effusion subsided and PSA dropped to 1.4 ng/ml from the initial 120 ng/ml at three months. Patient is on regular follow-up at three monthly intervals and last PSA done at 9 months was 2.1 ng/ml.

Humans↗
PubMedDate not supplied

Pattern of metastases in renal cell carcinoma: a single institution study.

BACKGROUND: Increasing numbers of patients with renal cell carcinoma (RCC) are incidentally detected and can be potentially cured by surgery alone. In treating metastatic RCC, worthwhile survival rates are achieved in cases of low burden recurrences. This necessitates a rational follow up protocol, which picks up early recurrences and avoids costly surveillance for those with a favorable prognosis. AIMS: We studied the patterns of metastases occurring in patients operated for localized or locally advanced renal cell carcinoma in the Indian setting and try to evolve a suitable follow up protocol. SETTING AND DESIGN: Institution based, retrospective data. METHOD AND MATERIALS: Records of patients from January 1988 to December 2003, operated for initially localized RCC were reviewed. Follow up was performed using an established protocol. Occurrence of metastases and their patterns were studied. STATISTICAL ANALYSIS USED: Comparison of the different survival times was performed using the one-way analysis method. Multiple comparisons (post hoc test) were performed using the Bonferroni method. RESULT: Follow up was available on 209 patients. Mean survival was 43.75 months (SD +/- 28.72). Thirty-nine patients developed 59 metastases. Lungs were the commonest site of metastases (37%), followed by bone (22%), liver (19%) and brain (8%). Relapse and survival showed significant correlation with pathological stage (p CONCLUSIONS: Occurrence of metastases correlate with the pathological stage of the disease at primary presentation. Tailored, stage-based follow up protocols allow adequate surveillance for disease activity and progression without escalating the overall costs.

Biopsy, Needle↗