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Biomedical subjects

M S Agrawal

Publications and source records attributed to M S Agrawal.

7 recordsLinked to original sources
PubMed1999

Endourological renal salvage in patients with calculus nephropathy and advanced uraemia.

OBJECTIVE: To document our experience with percutaneous nephrolithotripsy (PCNL) for the treatment of calculus nephropathy and advanced renal failure. PATIENTS AND METHODS: Between October 1989 and April 1996, 78 patients with calculus nephropathy (51 males and 27 females, mean age 42 years, range 16-67; mean serum creatinine level 663.8 micromol/L, range 282.8-1449.7) were treated in our department. Forty-six of the patients had bilateral upper urinary calculi, while the remaining 32 had a solitary functioning kidney obstructed by stone. Thirty-two patients had a normal urine output, 26 were oliguric and 20 presented with anuria. A preliminary percutaneous nephrostomy (PCN) was performed under local anaesthesia in 64 patients, and stone retrieved subsequently through the same nephrostomy track after improvement in their uraemic status. In the remaining 14 patients, the stones were removed at the first session. Of the 46 patients with bilateral stones, 21 underwent stone retrieval by PCNL on the contralateral side after an interval of 2-3 weeks, while 25 patients underwent simultaneous JJ stenting on the contralateral side, followed, after improvement in uraemic status, by delayed PCNL or extracorporeal shock wave lithotripsy on that side. RESULTS: There were three deaths, caused by overwhelming sepsis; 64 of the remaining 75 patients recovered well from uraemia, while 11 showed no improvement, suggesting irreversible renal damage. Complications included five patients with nonfatal sepsis and five with secondary haemorrhage. At the last follow-up 2.5-9 years after presentation, the mean serum creatinine level (271.3 micromol/L) was significantly better than the mean preoperative level. Six patients are on maintenance haemodialysis. CONCLUSIONS: It is not uncommon in developing countries for patients with urolithiasis to present with advanced uraemia caused by long-standing obstruction, almost invariably complicated by infection. A percutaneous endourological approach offers the best hope for these patients, and in our experience a significant percentage of these cases can be salvaged.

Adolescent↗
PubMed1999

Percutaneous suprapubic cystolithotripsy for vesical calculi in children.

BACKGROUND: The majority of vesical calculi in adults can now be treated per-urethrally with the use of ultrasonic or pneumatic lithotripsy. However, the use of these devices is restricted in pediatric patients by the narrow caliber of the urethra. A percutaneous suprapubic approach to the bladder circumvents the problem of urethral caliber in these situations. PATIENTS AND METHODS: Thirty-eight children presenting with bladder stones underwent percutaneous suprapubic cystolithotripsy (PCCL) between November 1989 and April 1996. The age ranged from 1.5 to 7 years. The stone size ranged from 0.8 to 2.4 cm. Seven of these were recurrent stones, and five of the patients were female. The procedure was done under general anesthesia, and the equipment was the same as for upper tract endourology. The bladder was distended with saline and a suprapubic puncture made. The nephroscope was introduced after tract dilation and the stone removed, intact if small or after fragmentation if >1 cm. The procedure was done without fluoroscopy. A suprapubic catheter was left in for 48 hours. RESULTS: All patients had an uneventful recovery following stone removal. The average hospital stage was 3 days. Here, the access provided by percutaneous suprapubic cystostomy has been combined with the experience gained in upper-tract endourology to perform procedures that would otherwise require open operation because of nonavailability of urethral access. CONCLUSION: Extension of endourologic procedures to the lower tract reduces morbidity and hospital stay and thus the cost of treatment. Percutaneous suprapubic cystolithotripsy, in our experience, is a safe and cost-effective alternative to open surgery in children.

Child↗
PubMed1981

Carcinoma of breast associated with pregnancy and lactation.

Out of 840 cases of breast carcinoma seen over a period of ten years, 18 were found to be associated with pregnancy and lactation. According to the mode of onset and presentation of the disease, these patients were divided into four groups. The average age of these patients was 31.9 years old. Thirteen out of 18 patients presented in a very advanced stage of the disease. In a short period, involvement of liver was noticed in 8, brain in 3, and bones and lung in 2 each. The disease was bilaterally simultaneous in two patients. The acceleration of growth was noticed during second and third trimesters of pregnancy as well as during lactation. The termination of pregnancy in three patients did not alter the clinical course of the disease.

Adult↗
PubMed1980

Dosimetry intercomparison for partial body x-irradiation of rats.

An X-ray dosimetry intercomparison for partial body irradiations has been performed among a number of laboratories cooperating within EULEP (European Late Effects Project Group) using mailed acrylic plastic rat phantoms. The main objective of this study was to assess the adequacy of exposure arrangements and dosimetry procedures applied to rat partial body irradiations at the participating institutes. The dose and dose distribution in lung and liver substitute material have been measured with dual thermoluminescent (TL) dosemeters LiF and CaF2:Mn. The doses from scattered radiation in the shielded parts of the phantom have also been assessed. The results of the dose intercomparison show that in the first instance six out of the eight participating institutes obtain dose values which differ by more than 5% from the standard dose. Inconsistencies are observed between the lung and liver doses administered at the same institute. After consultation, four institutes indicated the cause for their deviating dose values and quoted revised results which are closer to the standard value. Large dose gradients are measured, since six out of the eight participants applied unilateral exposures. This project has indicated the need for repeated intercomparisons and for improvements in dosimetry and irradiation procedures for partial body irradiations.

Animals↗
PubMed1979

Radiation myelopathy.

Five cases of radiation myelopathy were found in a total of 10,000 cases given radiotherapy from 1968 to 1977. The clinical presentation and treatment details including the total dose, treatment volume, number of fractionations, overall time, and the RET value at the spinal cord were calculated and compared with other reports on this subject. The total number of fractionations ranged from 20 to 26 with an overall time of 32 days to 37 days. The dose received by four patients ranged from 1030 to 1900 RET, a little higher than the tolerance level of the spinal cord as compared to reported values. Two patients in this series had high blood pressure. The incidence of radiation myelopathy, already acceptably low, could possibly be reduced further by meticulous planning of radiation.

Carcinoma, Squamous Cell↗