Biomedical subjects

Sanjay Razdan

Publications and source records attributed to Sanjay Razdan.

4 recordsLinked to original sources

PubMed2006

The camera phone: a novel aid in urologic practice.

OBJECTIVES: To describe a novel use of the camera phone for efficient, reliable, and cost-effective collection and transmission of medical data in the urologic setting. METHODS: We used camera phones (Verizon VGA and Sanyo-Sprint PCS) with a resolution of 640 x 480 pixels to capture images in the operating room, as well as in the outpatient clinic. Images were obtained directly from the monitor or the x-ray viewing box. These were then immediately transmitted to the office computer through a secure Internet connection. The images were then incorporated into operative and office notes, as needed. RESULTS: The images obtained with this method were of adequate quality for demonstration purposes, with the added advantage of allowing secure transmission and storage. The best-quality images were those obtained directly from the x-ray viewing box or from a liquid crystal display monitor. In addition, the images could be edited and labels added with the aid of the software that came with the camera phone. CONCLUSIONS: This method allows the acquisition of fair-quality digital images of surgical procedures and radiographic studies with simultaneous data transmission and storage for clinical documentation. The technology reduced costs and increased the efficiency of our practice considerably.

Cell Phone↗

PubMed2005

Current practice patterns in urologic management of upper-tract transitional-cell carcinoma.

PURPOSE: To determine the current practice patterns in the management of upper-tract transitional-cell carcinoma (TCC) among a large group of urologists. MATERIALS AND METHODS: A survey was sent to 220 practicing members of the Society of Urologic Oncology (SUO) and the Endourological Society (ES) and members of the American Urological Association who did not belong to either society. The survey consisted of 16 focused questions pertaining to the surveillance and management of upper-tract TCC. The responses were used to create a database, which was then analyzed to determine practice trends. RESULTS: Eighty-four of the urologists responded, for a response rate of 38%. Fourteen responses were excluded because of multiple answers to a given question, so 70 were included in the final analysis. Eighty percent of the respondents were in academic practice. A CT urogram was the favored initial procedure for diagnosis of upper-tract TCC and an intravenous urogram was the next commonest choice (53% and 40%, respectively). Ureterorenoscopy was the surveillance tool of choice (70%) after conservative treatment of upper- tract TCC. Laparoscopic nephroureterectomy was the preferred procedure (73%) for a high-grade, large renal-pelvic TCC. Twenty-one percent of the endourologists recommended ureteroscopic ablation for a high-grade, large distal ureteral tumor. This was in sharp contrast to 77% of the respondents who favored a distal ureterectomy for the same clinical scenario. CONCLUSIONS: This study confirms that most urologists treating upper-tract TCC follow the principles reported in the published literature regarding the management of these patients. Further, most urologists, regardless of society affiliations or years in practice, favor minimally invasive techniques for the management of upper-tract TCC. This information may be useful in formulating clear guidelines for the management of this disease.

Adult↗

PubMed2005

Ureteroscopic endoureterotomy.

OBJECTIVE: To highlight the current status of ureteroscopic endoureterotomy (UE) by reporting extensive experience with the endoscopic management of ureteric strictures, with special emphasis on factors determining success, and by reviewing publications on the minimally invasive management of ureteric strictures. PATIENTS AND METHODS: The study comprised 50 patients (mean age 53 years, range 18-85, equal sex distribution) with ureteric strictures of varying causes; all had their stricture treated endoscopically. The follow-up was 0.5-9 years; 10 patients with recurrent strictures had two ipsilateral stents placed to try to improve the outcome, and eight patients with completely obliterating strictures were treated by ureteroscopic re-canalization. RESULTS: The site of stricture had no bearing on the eventual outcome. Patients with uretero-enteric and malignant strictures did not fare so well. The most important predictor of failure was the length of the stricture, with failure in all seven patients with strictures of > 2 cm. In the 10 patients treated with two ipsilateral stents, eight were successful, which was very promising considering that these patients had recalcitrant strictures and placing one stent had previously failed. The overall success rate was 74%. CONCLUSION: UE has become the procedure of choice for the initial management of ureteric strictures. Simple balloon dilatation is also effective in certain situations. The characteristics of the stricture often govern the eventual outcome. In properly selected cases success rates of approximately 75% can be expected.

Adolescent↗

PubMed2003

Current practice patterns in the urologic surveillance and management of patients with spinal cord injury.

OBJECTIVES: To determine current trends in management and surveillance of the spinal cord injury (SCI) population among specialized urologists who routinely work and provide care to patients with SCI. There is a lack of consensus on the optimal urologic surveillance and management protocol of the urinary tract in SCI patients. METHODS: A mailed questionnaire was sent to the 269 American members of the Society for Urodynamics and Female Urology (SUFU). The type of investigation used in the assessment and follow-up of upper and lower urinary tract function in SCI patients and their optimal frequency and management modalities were the topics of inquiry. RESULTS: One hundred sixty of the 269 urologists responded for a response rate of 60%. Most physicians (85%) favor a yearly renal ultrasound for routine surveillance of the upper tracts, whereas more than half (65%) routinely use videourodynamic studies for evaluation of the lower urinary tract. The combination of clean intermittent catheterization (CIC) plus anticholinergic agents is the favored modality for management of hyperreflexic bladder, whereas CIC alone is preferred for the areflexic bladder. CONCLUSIONS: This study confirms that most urologists working with SCI patients follow principles reported in published data regarding the need for evaluation, surveillance, and management of the urinary tract. However, there is a lack of consensus in the specific methods used for surveillance of the urinary system. The present results emphasize the need for clear guidelines in this area.

Catheters, Indwelling↗