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Biomedical subjects

R Indudhara

Publications and source records attributed to R Indudhara.

At least 19 recordsLinked to original sources
PubMed1992

Tuberculous pyomyositis in a renal transplant recipient.

Infections are a major cause of morbidity and mortality in renal transplant recipients. Although these patients are susceptible to many types of infection, soft tissue infections are rare. We report a case of tuberculous pyomyositis involving the left erector spinae muscle but with no other manifestations of tuberculosis. The diagnosis was suspected from the CT scan appearance and confirmed by microscopy and culture of the pus. Surgical incision and drainage, together with antituberculosis therapy, cured the infection. The relevant literature is briefly reviewed.

Adult↗
PubMed1992

Case report: traumatic loss of the entire urethra and bladder neck in a girl--reconstruction by modified Flocks bladder tube.

Complete loss of the urethra and bladder neck secondary to pelvic fracture in a female patient is rare. We report a case of pelvic fracture resulting from a traffic collision leading to complete loss of the urethra including the bladder neck in an adolescent girl. A new urethra was reconstructed from a modified Flocks bladder tube and wrapped with omentum. At 2 years follow-up, the patient is fully continent and voiding satisfactorily. The problems of female urethral reconstruction are discussed.

Adolescent↗
PubMed1992

Chemodissolution of urinary uric acid stones by alkali therapy.

Experience with chemodissolution of uric acid stones in 30 patients is presented. Chemodissolution was achieved either with infusion of 0.16 M i.v. lactate or oral sodium bicarbonate, in addition to liberal fluid intake and allopurinol wherever indicated. In some cases direct chemodissolution by in situ irrigation with sodium bicarbonate solution was done after an initial percutaneous nephrostomy. Seven patients presented with acute obstructive anuria. In this group, 5 of them had bilateral obstructive calculi, while 2 had unilateral obstruction in a solitary kidney. The latter 2 had complete recovery following intravenous lactate therapy. Of the 5 presenting with bilateral obstruction, 2 patients had complete response to chemodissolution, whereas the remaining 3 had only a partial response requiring surgery for ultimate salvage. In this group I, 6 patients are doing well with a normal serum creatinine at 3 months to 4 years follow-up, while 1 patient has a serum creatinine, stabilised at 3.2 mg%. In the second group, 23 patients presented with non-obstructing urinary stones. Flank pain was the commonest complaint and a concomitant history of gout was present in 6 patients. Hyperuricaemia was detected in 12 and hyperuricosuria in 19. All cases were managed by high fluid intake and oral sodium bicarbonate, with self-monitoring of urine pH, which was kept between 6.5 and 7.0. Allopurinol was administered in cases having hyperuricaemia and/or hyperuricosuria. Systemic alkali therapy in the form of intravenous molar lactate or sodium bicarbonate is effective and safe both in obstructive anuria and non-obstructive urinary uric acid stones.

Aged↗
PubMed1992

Urethral tuberculosis.

Tuberculous affection of the urethra is very rare. Herein we report 2 cases of urethral tuberculosis. One in a young married female who had isolated urethral involvement presenting as urethral caruncle and the second in a young male with urethral stricture complicated by fistulae and abscess in association with renal tuberculosis. The relevant literature is briefly reviewed.

Adult↗
PubMed1992

Coexisting renal cell carcinoma and xanthogranulomatous pyelonephritis in a chronic calculous disease.

Association of renal cell carcinoma (RCC) with renal calculi is very rare. Herein we report a case of RCC developing in a non-functioning kidney containing multiple renal and ureteric calculi. Histologically, the kidney, in addition, revealed changes of xanthogranulomatous pyelonephritis (XGP). XGP can be confused clinically, grossly and microscopically with RCC. In the present case both were coexistent and thus make it interesting.

Carcinoma, Renal Cell↗
PubMed1992

Renal tuberculosis: diagnosis with sonographically guided aspiration cytology.

Sonographically guided fine-needle aspiration cytology was performed in 19 patients suspected to have renal tuberculosis. This procedure enabled a diagnosis of renal tuberculosis to be made in six of seven patients with urine cultures consistently negative for acid-fast bacilli and confirmed the diagnosis in nine patients with focal renal lesions on sonography and urine cultures positive for acid-fast bacilli. The fine-needle aspiration cytologic samples were positive for acid-fast bacilli in seven (44%) of the 16 confirmed cases, and acid-fast bacilli were present in 80% of the samples containing necrotic material. Epithelioid granulomas were present in 15 (94%) of 16 patients diagnosed with renal tuberculosis. One patient had no evidence of acid-fast bacilli or epithelioid granulomas, but seminal fluid ultimately grew acid-fast bacilli. Two patients (13%) with evidence of tuberculosis had minor self-limiting complications from the fine-needle aspiration: one perirenal hematoma and one abdominal wall intramuscular hematoma. Sonographically guided fine-needle aspiration cytology is useful as a means of diagnosing renal tuberculosis in patients with urine cultures negative for acid-fast bacilli, and is of value in defining the granulomatous nature of sonographically visible lesions in patients with positive urine cultures.

Biopsy, Needle↗
PubMed1992

Isolated invasive candidal prostatitis.

Fungal prostatitis is an uncommon entity. Herein we report a case of isolated candidal prostatitis in an elderly patient who presented with acute urinary retention and was clinically diagnosed as having benign hypertrophy of the prostate. Histology of the resected prostate demonstrated invasive prostatic involvement by Candida albicans. There was no evidence of systemic involvement by Candida. The relevant literature and treatment of isolated Candidal prostatitis have been highlighted.

Aged↗
PubMed1991

Fine-needle aspiration cytology in azoospermic males.

Bilateral testicular fine-needle aspiration cytology (FNAC) was performed in 100 males, including 10 controls with normal fertility and 90 infertile azoospermic males. The various seminiferous tubular cells were easily identified in smears. It was possible to give a cytological diagnosis in histologic terms by analysis of the combinations of various cell types. The cytohistologic correlation in 25 cases was nearly 100%. FNAC is particularly useful in cases of obstructive azoospermia, where mature spermatozoa are seen in smears.

Biopsy, Needle↗
PubMed1991

Seminal vesiculitis due to Mycobacterium gastri leading to male infertility.

Tuberculosis of the genitourinary tract is a well-known cause of male infertility. However, infertility from infection by nontuberculous mycobacterium has not been reported. Herein, we present a case of seminal vesiculitis due to Mycobacterium gastri in a diabetic patient leading to male infertility. Improvement in semen quality was noticed after 6 months of therapy with isoniazid, ethambutol and rifampicin.

Adult↗
PubMed1991

Sigmoid colon conduit urinary diversion in a renal transplant recipient.

Renal allotransplantation is the treatment of choice for patients with end-stage renal disease (ESRD). With increasing technical expertise, it has been realised that presence of a normal lower urinary tract is not a necessity for transplantation. Advanced genito-urinary tuberculosis frequently leads to a small-capacity bladder. Herein, we present a case of ESRD due to urinary tuberculosis in whom sigmoid colon conduit urinary diversion was carried out. The immunosuppressed status did not increase the complications of a sigmoid colon conduit urinary diversion.

Adult↗
PubMed1990

The use of percutaneous diversion during pregnancy.

Two patients with infected hydronephrosis and one patient with calculus anuria during pregnancy were managed initially by percutaneous nephrostomy. Maintenance of percutaneous diversion allowed continuation of pregnancy to term and effectively preserved renal function. Definite surgical treatment for the obstructive pathology was done electively in the postpartum period.

Adult↗
PubMed1990

Isolated testicular metastases from renal cell carcinoma.

Testicular metastasis from renal cell carcinoma is very rare. Herein we report a case of left-side renal cell carcinoma initially diagnosed to be clinically stage II, which developed left-side testicular metastases 2 months following radical nephrectomy. High inguinal orchiectomy was carried out. The patient was asymptomatic 2 months later. Although renal vein involvement in renal cell carcinoma is common and its extension into inferior vena cava well documented, tumour invasion of spermatic veins is rare.

Aged↗
PubMed1990

Effect of intravesical instillation of varying doses of verapamil (20 mg, 40 mg, 80 mg) upon urinary bladder function in chronic traumatic paraplegics with overactive detrusor function.

The effect of intravesical instillation of verapamil was studied in eight chronic, traumatic paraplegics. Cystometry was performed before and 2 h after intravesical instillation of 20 mg of verapamil. After a gap of 10 days, the study was performed with 40 mg of verapamil and after an interval of another 10 days, the effect of intravesical instillation of 80 mg of verapamil was studied. No side-effects were observed after the intravesical administration of 20 mg, 40 mg or 80 mg of verapamil. The intravesical volume at detrusor reflex activity or at first uninhibited detrusor contraction (IV-DR) showed no significant change after intravesical instillation of 20 mg; but IV-DR increased from 90 +/- 22 ml to 131 +/- 21 ml (p less than 0.001) after intravesical instillation of 40 mg of verapamil. There was a significant increase in IV-DR from 96 +/- 23 ml to 242 +/- 35 ml after intravesical instillation of 80 mg of verapamil (p less than 0.001). There was no significant change in detrusor pressure at detrusor reflex activity or at first uninhibited detrusor contraction after intravesical instillation of 20 mg, 40 mg or 80 mg of verapamil. The frequency of voiding recorded before and one day after intravesical instillation of either 20 mg or 40 mg of verapamil showed no significant change. But the frequency of voiding recorded before and one day after intravesical instillation of 80 mg of verapamil showed a significant decrease from 19 +/- 2 to 8 +/- 1 (p less than 0.001).

Administration, Intravesical↗
PubMed1990

Acute colitis in renal transplant recipients.

Gastrointestinal complications constitute an important cause of morbidity and mortality in renal transplant recipients. The present communication is based on our experience with 10 living related donor kidney transplant recipients who suffered from severe acute colitis in the posttransplant period. A specific etiological factor was detected in only one (atypical mycobacteria). Six patients succumbed to the illness in the acute stage, thus highlighting its seriousness. Various factors involved in etiology have been discussed, and early therapeutic intervention emphasized.

Acute Disease↗
PubMed1989

Postpyelolithotomy renal artery pseudo-aneurysm.

A case of pseudo-aneurysm arising from the posterior division of right renal artery following pyelolithotomy is presented. The patient presented with massive haematuria and flank mass 7 days after pyelolithotomy. Selective renal arteriography revealed large pseudo-aneurysm in relation to the posterior division of renal artery. Nephrectomy was necessitated to control the bleeding. The relevant literature is reviewed.

Adult↗
PubMed1988

Cyclophosphamide in renal transplantation.

Success in renal transplantation is now largely dependent on safe and effective immunosuppression. Nonspecific immunosuppression by chemical agents continues to be the mainstay of clinical immunosuppression. Azathioprine and prednisolone have remained the two main drugs used in combination in standard immunosuppressive therapy in renal transplantation for many years. Although cyclophosphamide (CP) was tried in the early years of transplantation, enthusiasm for its use was dampened by the advent of newer agents. We have analyzed our experience with 29 recipients of living-related donor (LRD) renal allotransplantation on cyclophosphamide therapy. Cyclophosphamide is a safe and effective alternative to azathioprine in clinical renal allotransplantation. Due to its easy availability and the fact that it is a cheaper alternative to azathioprine and cyclosporine, it is more significant for developing countries.

Adult↗