PubMed Health⌕ Search

Biomedical subjects

D Basak

Publications and source records attributed to D Basak.

11 recordsLinked to original sources
PubMed2001

Posterior urethral valves: the scenario in a developing center.

We have reviewed 233 patients with posterior urethral valves treated in a single center in Calcutta, India, over the last 20 years: 37 were neonates, 75 were between 1 and 12 months, 88 were between 1 and 5 years, and 33 were more than 5 years old when first seen. The clinical presentation and methods employed in diagnosis and assessment are described. Primary endoscopic valve ablation was performed in 140 patients (60%). One or other form of diversion was done in 100 (43%), 93 before and 7 either during or after valve ablation. The short- and long-term results have been studied. Eleven patients died during the initial hospitalization, 3 died subsequently, 15 are in end-stage renal disease, 17 are in poor health, and 18 have been totally lost to follow-up. The remaining 169 have been in good health for periods between 1 and 20 years. While our results of primary valve ablation in low-risk patients with responsible parents are as good as anywhere else in the world, we are concerned at our relatively high diversion rate and relatively poor long-term follow up; the methods being adopted to reduce these problems are discussed.

Child, Preschool↗
PubMed1996

Prospective comparison of colour Doppler ultrasonography and testicular scintigraphy in acute scrotum.

The aim of this prospective study was to compare the effectiveness of colour Doppler ultrasound and testicular scintigraphy in the differential diagnosis of acute scrotum. Ten patients were investigated by clinical examination initially and by both techniques afterwards. Scintigraphy was performed in a blind fashion. According to the findings, 3 patients were categorized as acute ischaemia and 7 as inflammation. The 3 patients diagnosed as ischaemia underwent surgical exploration. Both imaging techniques predicted ischaemia (100%). In the inflammation group conservative therapy and follow-up were chosen. Ultrasonography alone established the correct diagnosis in 7/7, whereas scintigraphy in 5/7 of the patients.

Acute Disease↗
PubMed1996

Penile fracture: differential diagnosis, management and outcome.

OBJECTIVE: To determine the value of a diagnostic and therapeutic approach for patients presenting with acute penis and the effects of this management on the outcome. PATIENTS AND METHODS: The study comprises 21 consecutive patients (mean age 33.3 years, range 19-53) who presented with acute penis (acute pain and swelling during and soon after intercourse). The mean interval between the accident and the treatment was 6 h (range 2-20). All patients initially underwent cavernosography, followed by surgical exploration. RESULTS: Cavernosography showed extravasation of the contrast medium, indicating a corporal tear, in 19 of 21 patients. Surgical exploration revealed rupture of the deep dorsal vein in two patients whose radiological examinations were normal. In the remaining 19 patients, corporeal tears were repaired. The mean follow-up was 26.7 months; all patients regained penile function (potency). Penile curvature was the only adverse effect in three of the 21 patients, all of whom presented for medical treatment relatively late after the initial accident. CONCLUSION: In the management of the acute penis, cavernosography should be performed first and the treatment policy should be determined from the radiological findings. Conservative therapy should be chosen only when the corporeal bodies are intact.

Adult↗
PubMed1996

Correlation of ultrastructural alterations in cavernous tissue with the clinical diagnosis vasculogenic impotence.

Cavernous tissues of 27 impotent and 4 potent men were evaluated in order to determine the ultrastructural changes in patients with vasculogenic impotence. Tissue samples were obtained during penile prosthesis insertions and surgical repairs of penile fractures in impotent and potent patients, respectively. For the clinical evaluation (pharmacologic color Doppler ultrasound, dynamic pharmacocavernosometry and nocturnal penile tumescence monitoring) patients were divided into three groups: slight/moderate arterial dysfunction (n = 5), severe arterial dysfunction (n = 9) and purely cavernous erectile dysfunction (n = 9). No significant ultrastructural alteration was noticed in the group with moderate arterial dysfunction; decrease and deterioration of smooth muscle cells was the prominent finding in the severe arterial and venogenic dysfunction groups. Preliminary examination of cavernous tissue may be a part of routine evaluations in the approach to the management of erectile dysfunction.

Adult↗
PubMed1996

Judgment of color Doppler ultrasound with respect to cavernous artery occlusion pressure in dynamic infusion cavernosometry when evaluating arteriogenic impotence.

This prospective study was designed to compare the parameters obtained by color Doppler ultrasound to cavernous artery occlusion pressure measured by dynamic pharmacoinfusion cavernosometry in evaluating arterial components of erectile dysfunction. Four indexes were determined as parameters of sonography to indicate arterial competence. Indexes 1 and 2 reflected peak systolic velocities with respect to the cut-off values 25 and 30 cm/s after pharmacological stimulation with 60 mg papaverine hydrochloride respectively. Index 3 was the percentage of diameter changes in cavernosal arteries which was expected to be > 75%. The sum of the percents of increases in diameters of both cavernosal arteries which should be > 200, formed index 4. The sensitivity, specificity, positive predictive value and accuracy rates were 76, 100, 100 and 90% for index 2. These values were 50, 100, 100 and 71% for index 1. Very low statistical values were obtained for indexes 3 and 4. Although the gold standard in the diagnosis of arterial impotence is pharmacoangiography, color Doppler sonography using the parameter peak systolic flow rate > 30 cm/s may be a reliable, easily obtained, noninvasive technique for evaluating arterial components of erectile dysfunction.

Adult↗
PubMed1996

Renal hemodynamics in patients with obstructive uropathy evaluated by color Doppler sonography.

OBJECTIVES: Prior animal studies have shown through direct pressure measurements that there is a definite rise in the renal vascular resistance in obstruction. Therefore intrarenal hemodynamic changes can be determined by the vascular impedance expressed as pulsatility and resistive indexes (PI and RI) obtained from the Doppler waveforms of intrarenal arteries. We investigated whether various degrees of obstruction result in different hemodynamic responses according to color Doppler sonography. METHODS: 22 kidneys with varied degrees of hydronephrosis and 19 normal kidneys were examined. The pulsatility and resistive index of Doppler waveforms from interlobar arteries were obtained. The grade of hydronephrosis was based upon the width of parenchyma. RESULTS: The mean resistive index in the study and controls were 0.70 +/- 0.07 and 0.60 +/- 0.03, respectively. The difference was significant (p < 0.001). Pulsatility indexes in the study and controls were 1.07 +/- 0.34 and 0.98 +/- 0.23, respectively. The difference was not significant (p > 0.005). Significant difference was also noticed in the parenchymal widths between both groups (p < 0.001). CONCLUSION: It appeared that intrarenal color Doppler sonography can provide physiologic information reflecting renal vascular resistance status by means of an easily obtained parameter: resistive index.

Adolescent↗
PubMed1995

Value of color Doppler sonography in the diagnosis of venous impotence.

The gold standard in the diagnosis of venous impotence is cavernosometry. But a less invasive and time-consuming screening test for patients with a high probability of venous impotence is required. Therefore we evaluated 82 men with erectile dysfunction by color Doppler sonography after intracavernosal injection of 60 mg papaverine. 28 of them who had a poor erectile response but sufficient arterial inflow were included in this study. 6 patients who were previously found to have psychogenic impotence formed the control group. After pharmacological stimulation by papaverine, all patients were examined for 20 min by color Doppler sonography in order to detect diastolic flow velocities in the cavernosal arteries and erectile responses. Both groups of patients underwent pharmaco-cavernosometry in a blind fashion afterwards. The diagnosis of venous impotence with color Doppler sonography was confirmed by dynamic pharmaco-cavernosometry in 25 of 28 (89%) and 6 of 6 (100%) subjects of the study and control groups, respectively. Statistically, in the diagnosis of venous dysfunction, color Doppler sonography had a sensitivity of 100%, specificity of 66.6%, accuracy rate of 91% and a positive predictive value of 0.892. The gold standard in the diagnosis of venous impotence is still cavernosometry, but it seems that color Doppler sonography may provide a sensitive assessment of penile venous competence.

Adult↗