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Biomedical subjects

S Vaidyanathan

Publications and source records attributed to S Vaidyanathan.

At least 145 records · Page 8Linked to original sources
PubMed1989

Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report).

A case of xanthogranulomatous pyelonephritis (Stage-I: Nephric) with ureteral involvement is described. The patient had undergone right nephrectomy with the working diagnosis of calculus pyonephrosis and non-functioning kidney. Histopathological examination of the nephrectomy specimen revealed xanthogranulomatous pyelonephritis confined to the kidney and non-contiguous involvement of ureter. Post-operative recovery was uneventful and there had been no evidence of disease recurrence till one year's follow-up.

Humans↗
PubMed1989

Effect of diclofenac-Na on 24-hour urinary excretion of creatinine, calcium, uric acid and glycosaminoglycans in adult patients with recurrent calcium oxalate nephrolithiasis.

Non-steroidal anti-inflammatory drugs (NSAID viz. indomethacin, flurbiprofen) decrease urinary calcium excretion in male Sprague-Dawley rats. Indomethacin decreases significantly the urinary calcium excretion in hypercalciuric patients. These observations encouraged the use of NSAID in the treatment of nephrolithiasis with encouraging initial results. However, NSAID (indomethacin and naproxen) retard both glycosaminoglycans (GAGs) synthesis and degradation thereby causing a significant reduction in the urinary excretion of GAGs, known to be potent inhibitors of calcium oxalate crystallization. Therefore, the effect of another NSAID, diclofenac-Na (50 mg t.i.d. for 4 weeks) was studied on 31 recurrent calcium oxalate nephrolithiasis patients who were not hypercalciuric or hyperuricosuric. The 24-h urinary excretion of creatinine, calcium and uric acid remained unchanged at 2 weeks and 4 weeks of therapy. However, after treatment of 2 weeks and 4 weeks, there was a significant decrease in the 24-h urinary excretion of GAGs (from 17.04 +/- 7.39 mumol to 11.54 +/- 7.02 and 12.7 +/- 6.2 mumol, respectively), and urinary concentration of GAGs (from 10.77 +/- 7.09 mumol/l to 6.03 +/- 5.00 mumol/l and 7.35 +/- 4.81 mumol/l, respectively). Thus diclofenac-Na (50 mg t.i.d.) did not reduce urinary excretion of calcium but significantly lowered the urinary excretion and concentration of GAGs in normocalciuric nephrolithiasis patients, an observation which cautions against the use of diclofenac-Na in prevention of nephrolithiasis in this group of patients.

Adult↗
PubMed1989

Lowering of maximum urethral pressure by (D-Met2, Pro5)-enkephalinamide in patients with neurogenic vesicourethral dysfunction due to spinal cord injury.

The effect of (D-Met2, Pro5)-enkephalinamide upon urethra in patients with chronic neurogenic vesicourethral dysfunction due to spinal cord injury was investigated. Urethral pressure profile was recorded with Urolab 1154 and 1700A urethral pressure profile puller-pump. Ten mg of the drug was administered subcutaneously. Urethral pressure profile was again recorded at 10, 20, 30, 40, 50 and 60 min after drug administration. Heart rate was also noted at these time points. There was a significant decrease in maximum urethral pressure from 134 +/- 19 cm H2O in the basal study to 107 +/- 28 cm H2O at 10 min (p less than 0.01); 102 +/- 30 cm H2O at 20 min (p less than 0.001); 94 +/- 19 cm H2O at 30 min (p less than 0.001); 100 +/- 20 cm H2O at 40 min (p less than 0.001); 102 +/- 29 cm H2O at 50 min (p less than 0.001); and 109 +/- 36 cm H2O at 60 min (p less than 0.001) after subcutaneous administration of (D-Met2, Pro5)-enkephalinamide. There was a significant increase in heart rate from 81 +/- 5 to 95 +/- 9 at 10 min (p less than 0.01) and to 87 +/- 10 at 20 min (p less than 0.01) after the drug. Subsequenly, the heart rate returned to near-basal values. The side effects were: conjunctival injection in all the cases; dryness of mouth in two; itching over the body in one; sensation of insect crawling over the body in one; and feeling of oppression over the chest immediately after drug administration in one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Management of vesico-uterine fistulae: a report of six cases.

Six cases of vesico-uterine fistulae caused by cesarean section in four and pelvic trauma in two cases were treated during the past 15 years. Both the cases of vesico-uterine fistulae due to pelvic trauma and one case of vesico-uterine fistula due to cesarean section in whom the fistula was detected in the early post-operative period, could be managed successfully by suprapubic urinary diversion and control of infection. Two patients who were seen more than 1 year after the cesarean section, were cured by trans-abdominal closure of the fistula with omental interposition. One patient who reported 3 months after the cesarean section was managed by estrogen and progesterone-induced amenorrhea. The management protocol for vesico-uterine fistula should thus be individualised taking into consideration the etiology, and time interval between its occurrence and institution of treatment regimen.

Cesarean Section↗
PubMed1988

Results of surgical reconstruction in patients with renal failure owing to ureteropelvic junction obstruction.

During the last 6 years we managed 20 patients with renal failure owing to bilateral ureteropelvic junction obstruction (12) or ipsilateral ureteropelvic junction obstruction with contralateral renal agenesis, hypoplasia or dysplasia (8). Of the patients 11 underwent emergency dialysis for hyperkalemia, fluid overload or metabolic acidosis. Mean serum creatinine at presentation was 6.5 mg. per cent. Preliminary decompression of the obstructed kidney was done in 14 patients (20 renal units) with a serum creatinine of more than 3 mg. per cent at presentation. Reconstruction was done in all patients (31 of 36 renal units) after decompression and control of infection. Pyeloplasty was done in 24 renal units, vesicopyelostomy in 3 pelvic kidneys and calicoureteroplasty in 2 renal units with an intrarenal pelvis. Two renal units were removed. All patients showed improvement in renal function and the mean postoperative serum creatinine value was 2.05 mg. per cent. The postoperative serum creatinine value showed a significant positive correlation with the initial value as well as with the initial blood urea levels. However, the postoperative serum creatinine value showed no correlation with patient age, duration of symptoms, serum creatinine level after preliminary nephrostomy and presence or absence of urinary infection. Postoperative recovery (on the basis of postoperative serum creatinine levels) in patients who had bilateral ureteropelvic junction obstruction was not different from those with a solitary functioning kidney and ureteropelvic junction obstruction.

Acute Kidney Injury↗
PubMed1988

Development of fatal bilateral xanthogranulomatous pyelonephritis in a paraplegic patient: case report.

The first case of a bilateral xanthogranulomatous pyelonephritis (XGPN) is reported in a paraplegic patient who did not practise intermittent catheterisation after discharge from the hospital but resorted to the Crede manoeuvre which predisposed to a fatal urinary tract infection and development of XGPN over a period of 5 weeks. The advantages of clean, unsterile, intermittent self catheterisation over the Crede manoeuvre in patients with a neuropathic bladder are discussed especially in preventing infective complications of the upper urinary tract which may prove life threatening as occurred in this patient.

Adult↗
PubMed1988

Hyponatraemia and mental symptoms following vesical ultrasonic lithotripsy.

A patient became confused and restless after vesical ultrasonic lithotripsy performed with distilled water as the irrigant. Serum sodium decreased to 120 mmol/litre from the pre-operative value of 138 mmol/litre. A cystogram revealed intraperitoneal extravasation of contrast. She recovered promptly after intravenous infusion of normal saline and emergency surgery for repair of the damaged bladder wall. This case illustrates that hyponatraemia and mental symptoms similar to those following transurethral resection syndrome also occur with ultrasonic lithotripsy when distilled water is used as the irrigant.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMed1988

Vesicopyelostomy in the treatment of pelvic kidneys with pelviureteric junction obstruction: long-term follow-up.

The surgical management of 6 male patients with pelvic kidneys with pelviureteric junction obstruction is discussed. Two patients presented in advanced renal failure and 1 had peritonitis and septicaemia due to rupture of the renal pelvis. Vesicopyelostomy was preferred to pyeloplasty in 5 patients because of adhesions, multiple aberrant vessels, multiple stones, malrotation and the low pelvic position, but pyeloplasty was done in 1 case. Though vesicoureteric reflux was observed during voiding cystourethrography in all patients, no deleterious effect on the kidney was seen during the 3- to 5-year follow-up period.

Adolescent↗
PubMed1988

Chronological variation in chemical composition of urinary calculi between 1965-68 and 1982-86 in north western India.

The chemical composition of 210 urinary calculi either spontaneously passed or surgically removed during January 1965-December 1968 was compared with the chemical composition of 1338 urinary calculi received during July 1982-June 86. The proportion of vesical calculi had significantly decreased from 30.48% (n = 64) during 1965-68 to 8.37% (n = 112), during 1982-86 (p less than 0.001). During 1965-68, magnesium was present in 16%, ammonium in 31% and urate in 33% of vesical calculi. But during 1982-86, the percentage of vesical calculi containing magnesium and ammonium was nil (p less than 0.001), but 76.8% of vesical calculi contained urate (p less than 0.001). Similarly, during 1965-68, 35.6% of renal calculi containing magnesium, 20% contained ammonium, 13.6% contained carbonate and urate was present in 32.2% of renal calculi. In contrast during 1982-86, magnesium was detected in only 0.24% of renal calculi (p less than 0.001), ammonium in 0.16% (p less than 0.001) and carbonate in 3.9% (p less than 0.001) but 57.4% of renal calculi contained urate (p less than 0.001).

Adolescent↗
PubMed1988

Control of massive vesical hemorrhage due to radiation cystitis with intravesical instillation of 15 (s) 15-methyl prostaglandin F2-alpha.

Intravesical instillation of 15 (s) 15-methyl prostaglandin F2-alpha (1 mg in 100 ml of normal saline on days 1 and 2, and 0.5 mg in 50 ml of normal saline on days 3 and 4) controlled massive vesical hemorrhage due to radiation cystitis in a 60-year female with carcinoma of uterine cervix. With the 1 mg dose, she developed severe bladder spasms and mild fever. No cardiac or respiratory side effect was observed.

Aged↗
PubMed1988

A comparative study of the diuretic, natriuretic, and kaluretic effects of furosemide when administered at 07:00 h and at 19:00 h.

Furosemide (0.5 mg/kg, i.v.) was administered to 31 healthy, day-active adults (Group 1) at 07:00 h (study 1) and urine output during the next 2 h was collected. Urine volume, urinary sodium, potassium and creatinine were determined. After 60 h, furosemide (0.5 mg/kg, i.v.) was administered at 19:00 h (study 2) and urine output during the subsequent 2 h (19:00 h to 21:00 h) was collected for estimation of urine volume, sodium, potassium and creatinine. Twenty-two healthy, day-active adults (Group 2) who constituted the control group underwent study 1 and study 2 and received 2 ml of normal saline instead of furosemide. There was no significant difference in urinary volume, urinary sodium, potassium and creatinine excretion between study 1 and study 2 in the control subjects (Group 2). In contrast, administration of furosemide at 07:00 h (study 1) resulted in greater diuresis (247.1 +/- 202.07 ml), more marked sodium excretion (42.66 +/- 29.06 mmol), increased potassium excretion (5.14 +/- 4.014 mmol), and greater creatinine excretion (0.415 +/- 0.414 mmol) as compared to study 2. In conclusion, the diuretic, natriuretic and kaluretic effects of furosemide are greater when administered at 07:00 h than at 19:00 h. Therefore, in clinical practice, the time of administration of furosemide can be so chosen as to achieve a greater diuresis or to prevent a marked loss of sodium.

Adult↗