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Siddharth Pandey,Satyanarayan Sankhwar,Apul Goel,Manoj Kumar,Ajay Aggarwal,Deepanshu Sharma,Samarth Agarwal,Tushar Pandey 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.2
Purpose: To analyze the utility of quick Sequential Organ Failure Assessment (qSOFA) in patients with uro-sepsis due to acute pyelonephritis (APN) with upper urinary tract calculi, we conducted this study. The role of qSOFA as a tool for rapid prognostication in patients with sepsis is emerging. But there has been a great debate on its utility. Literature regarding utility of qSOFA in uro-sepsis is scarce. Materials and Methods: Ours was a retrospective study including 162 consecutive patients who were admitted for APN with upper urinary tract calculi over a 3 and half years (total 42 months) period. We evaluated the accuracy of qSOFA in predicting inhospital mortality and intensive care unit (ICU) admissions and compared this with the predictive accuracy of systemic inflammatory response syndrome (SIRS). We used the Area Under Curve (AUC) of the Receiver Operator Characteristic curve to calculate it and also calculated the optimum cut off for qSOFA score. Results: The overall mortality and ICU admission rates were 7.4% and 12.9%, respectively. qSOFA had a higher predictive accuracy for in-hospital mortality (AUC, 0.981; 95% confidence interval [CI], 0.962–1.000) and ICU admissions (AUC, 0.977; 95% CI, 0.955–0.999) than SIRS. A qSOFA score of ≥2 was an optimum cut off for predicting prognosis. In a multivariate model qSOFA ≥2 was a highly significant predictor of in-hospital mortality and ICU admissions (p<0.001). Conclusions: qSOFA is a reliable and rapid bedside tool in patients with sepsis with accuracy more than SIRS in predicting inhospital mortality and ICU admissions.
Siddharth Pandey,Deepanshu Sharma,Satyanarayan Sankhwar,Manmeet Singh,Gaurav Garg,Ajay Aggarwal,Ashish Sharma,Samarth Agarwal 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.6
Purpose: To compare patients with sepsis due to obstructive urolithiasis (Sep-OU) and underwent drainage by percutaneous nephrostomy (PCN) or a double-J (DJ)-ureteral stent and to identify predictive risk factors of DJ stent failure in these patients. Materials and Methods: We reviewed our records from January 2013 to July 2018 and identified 286 adult patients with Sep-OU out of which 36 had bilateral involvement, thus total 322 renal units were studied. Urologic residents in training carried out both ureteral stenting and PCN tube placement. Demographic data and stone characteristics were recorded along with Charlson comorbidity index. For predicting risk factors of DJ stent failure, those variables that had a p-value <0.1 in univariate analysis were combined in a multinomial regression analysis model. Results: The patients with PCN placement were significantly older than those with DJ stent placement (p=0.001) and also had significant number of units with multiple calculi (p=0.018). PCN was also placed more frequently in those patients with a upper ureteric calculi (p<0.05). On multinomial regression analysis multiple calculi (p=0.014; odds ratio [OR], 4.878; 95% confidence interval [CI], 1.377–17.276) and larger calculi size (p=0.040; OR, 0.974; 95% CI, 0.950–0.999) were the significant predictors of DJ stent failure. Conclusions: In patients with sepsis from obstructive urolithiasis due to larger and multiple calculi a PCN placement might be better suited although this data requires further prospective randomized studies to be extrapolated.
Manoj Kumar,Siddharth Pandey,Ajay Aggarwal,Deepanshu Sharma,Gaurav Garg,Samarth Agarwal,Ashish Sharma,Satyanarayan Sankhwar 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.5
Purpose: To see the 30-day unplanned readmission rates in patients underdoing endo-urological surgeries for upper urinary tract calculi we conducted this retrospective study at King George's Medical University, Lucknow, India. Unplanned readmissions not only add to healthcare costs but also are bothersome for the patients. There are many studies on 30-day unplanned readmissions in general surgical patients. Although similar studies have been done in certain urological procedures, no study has reported readmission rates or its risk factors in patients undergoing surgeries for upper urinary tract calculi. Materials and Methods: We retrospectively reviewed our prospectively maintained database from 1st January 2009 to 31st December 2017, for the patients who underwent endo-urological procedures for upper urinary tract calculi and identified the patients who were re-admitted within 30 days of discharge. Results: Out of the total 3,209 patients undergoing endo-urological procedures for upper urinary tract calculi 56 were re-admitted. The readmission rate was 1.74% over the study period. The most common etiology for readmission was sepsis followed by hematuria. The significant risk factors for readmission in bivariate analysis included male gender, age >65 years, current smoking, chronic obstructive pulmonary disease, diabetes mellitus, bleeding disorder, prior cardiac disease, and American Society of Anesthesiologists (ASA) class ≥3. In multivariate risk adjusted logistic regression analysis ASA class ≥3 was the only independent risk factor for readmission. Conclusions: The readmission rates in endo-urological procedures for urolithiasis are less compared to other procedures. ASA class ≥3 is the most important independent predictor of unplanned 30-day readmissions.
Raj K. Singh,Shubham Pandey,Rakesh C. Saxena,Gananath D. Thakre,Neeraj Atray,Siddharth S. Ray 한국공업화학회 2015 Journal of Industrial and Engineering Chemistry Vol.26 No.-
Two additives CySBE-A and B were prepared via a two step synthesis. First, the cystine schiff base (CySB) was synthesized utilizing 3,5-di-t-butyl-4-hydroxybenzaldehyde. In the second step, its esterification with lauroyl alcohol and 2-ethyl hexanol results the final products CySBE-A and B respectively. Both additives were evaluated as multifunctional additive in polyol base oil for antioxidant, antifriction, antiwear and anticorrosion property. Universal oxidation test (IP-306) was used for evaluating antioxidant property. Antifriction and antiwear properties in terms of average friction coefficient and wear scar diameter (WSD) were evaluated using four ball test. The CySBE-A was found to be effective than CySBE-B.
Manmeet Singh,Samarth Agarwal,Apul Goel,Manoj Kumar,Ashish Sharma,Siddharth Pandey,Satynarayan Sankhwar 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.3
Purpose: We report the results and experience of a tertiary care center in laparoscopic transperitoneal heminephrectomy for the treatment of a non-functioning upper pole moiety of duplex kidney in adults. Materials and Methods: The key point of the technique included the placement of a 6-Fr ureteric catheter in the healthy ureter at the beginning of the procedure under fluoroscopic guidance cystoscopically. A standard laparoscopic 3- to 4-port placement was done after placing the patient in a 45 to 90 degrees lateral decubitus position. The upper pole was mobilized transperitoneally and transected using a harmonic scalpel. Results: A total of 17 patients aged 19 to 44 years underwent laparoscopic upper pole heminephrectomy. All patients had a complete duplicated renal collecting system on the ipsilateral side. Three patients were found to have ureterocele. The average blood loss was minimal (50–150 mL) with a mean of 95 ml. None of the patients required any blood transfusions. The mean operative time was 220 minutes (range, 160–315 minutes). The average length of hospital stay was 3 days (range, 2–4 days). Only 2 patients had Clavien-Dindo grade 3a complications, which were managed by double J stenting and percutaneous aspiration, respectively. Conclusions: Laparoscopic heminephrectomy is playing a cornerstone role in the treatment of the non-functioning moiety of duplex kidneys. The procedure is safe, efficient and offers the typical preoperative and postoperative benefits of laparoscopic surgery. The rate of complications in adults is acceptable and is similar to that reported in pediatric patients.
Current Status of Stem Cell Treatment for Type I Diabetes Mellitus
Anupama Kakkar,Ashima Sorout,Mahak Tiwari,Pallavi Shrivastava,Poonam Meena,Sumit Kumar Saraswat,Supriya Srivastava,Rajan Datt,Siddharth Pandey 한국조직공학과 재생의학회 2018 조직공학과 재생의학 Vol.15 No.6
BACKGROUND: Diabetes mellitus is a major health concern in current scenario which has been found to affect people of almost all ages. The disease has huge impact on global health; therefore, alternate methods apart from insulin injection are being explored to cure diabetes. Therefore, this review mainly focuses on the current status and therapeutic potential of stem cells mainly mesenchymal stem cells (MSCs) for Type 1 diabetes mellitus in preclinical animal models as well as humans. METHODS: Current treatment for Type 1 diabetes mellitus mainly includes use of insulin which has its own limitations and also the underlying mechanism of diseases is still not explored. Therefore, alternate methods to cure diabetes are being explored. Stem cells are being investigated as an alternative therapy for treatment of various diseases including diabetes. Few preclinical studies have also been conducted using undifferentiated MSCs as well as in vitro MSCs differentiated into b islet cells. RESULTS: These stem cell transplant studies have highlighted the benefits of MSCs, which have shown promising results. Few human trials using stem cells have also affirmed the potential of these cells in alleviating the symptoms. CONCLUSION: Stem cell transplantation may prove to be a safe and effective treatment for patients with Type 1 diabetes mellitus.