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Kumar S, Nagasubramanian S, Jacob Philip George A, Thampi John N, Devasia A, Joy M. Comparison of early surgical outcomes of laparoscopic partial nephrectomy between T1a and T1b renal tumors with the incorporation of EAUiaiC in the “trifecta” – a retrospective study reported according to EAU standardized quality criteria. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00961-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cheriyan A, Mukherjee P, Devasia A. Emphysematous pyelonephritis mimicking a groin swelling—A rare presentation. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Pai R, Ebenazer A, Paul MJ, Thomas N, Nair A, Seshadri MS, Oommen R, Shanthly N, Devasia A, Rebekah G, Jeyaseelan L, Rajaratnam S. Mutations seen among patients with pheochromocytoma and paraganglioma at a referral center from India. Horm Metab Res 2015; 47:133-7. [PMID: 24977658 DOI: 10.1055/s-0034-1376989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Determining the mutational status of susceptibility genes including RET, VHL, SDHx (SDHB, SDHC, SDHD) among patients with pheochromocytoma/paraganglioma (PCC/PGL) is gaining importance. These genes have not been systematically characterized among patients with PCC/PGL from India. The aim of the work was to screen the most frequently mutated genes among patients with PCC/PGL to determine the frequency and spectrum of mutations seen in this region. Fifty patients with PCC/PGL treated at our tertiary care hospital between January 2010 and June 2012 were screened for mutations in susceptibility genes using an algorithmic approach. Thirty-two percent (16/50) of patients were found to be positive for mutations including mutations among RET (n=4), VHL (n=6), SDHB (n=3), and SDHD (n=3) genes. None of these patients were positive for SDHC mutations. A significant association was found between young patients with bilateral tumors and VHL mutations (p=0.002). Two of the 3 patients with extra-adrenal SDHB associated tumors, had unique mutations, viz., c.436delT (exon 5) and c.788_857del (exon 8), one of which was malignant. High frequency of mutations seen among patients in this study emphasizes the need to consider mutational analysis among Indian patients with PCC/PGL.
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Affiliation(s)
- R Pai
- Department of Pathology, Christian Medical College, Vellore, India
| | - A Ebenazer
- Department of Pathology, Christian Medical College, Vellore, India
| | - M J Paul
- Department of Endocrine Surgery, Christian Medical College, Vellore, India
| | - N Thomas
- Department of Endocrinology and Metabolism, Christian Medical College, Vellore, India
| | - A Nair
- Department of Endocrine Surgery, Christian Medical College, Vellore, India
| | - M S Seshadri
- Department of Endocrinology and Metabolism, Christian Medical College, Vellore, India
| | - R Oommen
- Department of Nuclear Medicine, Christian Medical College, Vellore, India
| | - N Shanthly
- Department of Nuclear Medicine, Christian Medical College, Vellore, India
| | - A Devasia
- Department of Urology, Christian Medical College, Vellore, India
| | - G Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - L Jeyaseelan
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - S Rajaratnam
- Department of Endocrinology and Metabolism, Christian Medical College, Vellore, India
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Abrol N, Devasia A. Disintegrating perineal disease: A variant of watering-can perineum. African Journal of Urology 2014. [DOI: 10.1016/j.afju.2014.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abrol N, Deshpande AV, Berry CS, Devasia A. Scrotal pop off in a congenital anterior urethral diverticulum. J Pediatr Urol 2014; 10:775.e1-2. [PMID: 24928476 DOI: 10.1016/j.jpurol.2014.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 04/19/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated. PATIENT AND METHODS A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function. RESULTS Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms. CONCLUSION Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient.
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Affiliation(s)
- N Abrol
- Department of Urology, Christian Medical College, Vellore, Tamilnadu, India.
| | - A V Deshpande
- Department of Urology, Christian Medical College, Vellore, Tamilnadu, India.
| | - C S Berry
- Department of Urology, Christian Medical College, Vellore, Tamilnadu, India.
| | - A Devasia
- Department of Urology, Christian Medical College, Vellore, Tamilnadu, India.
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RAO A, BS V, Devasia A. Radiological quiz - genitourinary. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.29072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- A RAO
- Department of Radiodiagnosis1 and Department of Urology2 - Christian Medical College, Vellore -632004., Tamilnadu, India
| | - Viswaroop BS
- Department of Radiodiagnosis1 and Department of Urology2 - Christian Medical College, Vellore -632004., Tamilnadu, India
| | - A Devasia
- Department of Radiodiagnosis1 and Department of Urology2 - Christian Medical College, Vellore -632004., Tamilnadu, India
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Gopalakrishnan G, Adhikary S, Devasia A, Gnanaraj L, Chacko KN, Kekre N. Is shock wave lithotripsy safe in bleeding diathesis? Indian J Urol 2006. [DOI: 10.4103/0970-1591.26565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bhagat S, Viswaroop B, Devasia A, Chacko N, John G, Gnanaraj L. An Unusual Complication of Laparoscopic Tenckhoff Catheter Insertion. Perit Dial Int 2006. [DOI: 10.1177/089686080602600123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- S.K. Bhagat
- Department of Urology Christian Medical College Vellore, India
| | - B. Viswaroop
- Department of Urology Christian Medical College Vellore, India
| | - A. Devasia
- Department of Urology Christian Medical College Vellore, India
| | - N. Chacko
- Department of Urology Christian Medical College Vellore, India
| | - G.T. John
- Department of Urology Christian Medical College Vellore, India
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Bhagat SK, Viswaroop B, Devasia A, Chacko N, John GT, Gnanaraj L. An unusual complication of laparoscopic Tenckhoff catheter insertion. Perit Dial Int 2006; 26:114-5. [PMID: 16538888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
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Sinha M, Kekre NS, Chacko KN, Devasia A, Lionel G, Pandey AP, Gopalakrishnan G. Does Failure to Visualize the Ureter Distal to an Impacted Calculus Constitute an Impediment to Successful Lithotripsy? J Endourol 2004; 18:431-5; discussion 435. [PMID: 15253812 DOI: 10.1089/0892779041271625] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A severe degree of ureteral obstruction is viewed as a predictor of poor outcome in shockwave lithotripsy (SWL). Impacted stones are often considered a contraindication to in-situ SWL. PATIENTS AND METHODS Impaction in our study was defined as failure to visualize the ureter distal to the calculus with proximal hold-up of contrast for as long as 3 hours on an intravenous urogram (IVU). We evaluated 30 patients with impacted ureteral calculi, who were compared with a second unimpacted group matched for stone size and stone location. The calculi were reorganized into < or =10-mm and >10-mm groups. The results were compared in terms of clearance rates, number of shockwaves, number of sessions, and number of days between the start of SWL and clearance. RESULTS Between January 1998 and December 2001, 30 impacted stones were treated with lithotripsy. Complete clearance rates in the impacted as well as the non-impacted group were 76.7%. There was no statistical difference in the number of shockwaves, sessions, or time to clearance. The results were poorer in lower-ureteral than upper-ureteral calculi, but this difference did not reach statistical significance. However, the differences between the < or =10-mm and >10-mm stones were statistically significant. CONCLUSION Impaction on an IVU does not affect the results of lithotripsy.
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Affiliation(s)
- M Sinha
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Tuckey J, Devasia A, Murthy L, Ramsden P, Thomas D. Is there a simpler method for predicting lower pole stone clearance after shockwave lithotripsy than measuring infundibulopelvic angle? J Endourol 2000; 14:475-8. [PMID: 10954301 DOI: 10.1089/end.2000.14.475] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Several anatomic factors influence the clearance of lower pole stones treated with shockwave lithotripsy (SWL). One of these is the infundibulopelvic angle, but its measurement is complex. METHODS We proposed a more simple measure of caliceal dependence, the caliceal pelvic height (CPH), which we defined as the distance between a horizontal line from the lowermost point of the calix containing the stone to the highest point of the lower lip of the renal pelvis. RESULTS In 62 patients who had SWL for solitary lower pole stones, a CPH < 15 mm was associated with a stone clearance rate of 92%, whereas with a CPH > or = 15 mm, the clearance rate was only 52% (p < 0.05). A majority (74%) of the patients with an infundibular width of > or = 5 mm were rendered stone free compared with 40% of those with a width of < 5 mm (p < 0.05). CONCLUSION Measurement of the CPH, in conjunction with other anatomic factors, may more accurately predict the outcome of SWL in patients with lower pole stones.
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Affiliation(s)
- J Tuckey
- Department of Urology, Faculty of Medicine and Health Science, University of Auckland, New Zealand.
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Abstract
The clinical presentation, radiological manifestations and response to therapy of seven cases of biopsy-proven eosinophilic cystitis seen over an 8-year period were evaluated retrospectively. All of the five men and two women had symptoms of dysuria and frequency, with haematuria in two cases. One developed acute painful retention. The urine was sterile in all. Radiological findings included bladder mass lesions and upper tract dilatation. Cystoscopy showed papillary, erythematous and ulcerative mucosal lesions, and in one instance a large mass lesion. The various procedures carried out were cold cup biopsies, transurethral resections, or fulgration of lesions and partial cystectomy. Medical therapy included non-steroidal anti-inflammatory drugs and prophylactic antibiotics to cover the procedures carried out. There was excellent symptomatic improvement in all patients. This is the largest single-centre experience reported, and is unusual as the majority of the patients in this series were men.
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Affiliation(s)
- A Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Gnanaraj J, Devasia A, Gnanaraj L, Pandey AP. Intermittent self catheterization versus regular outpatient dilatation in urethral stricture: a comparison. Aust N Z J Surg 1999; 69:41-3. [PMID: 9932920 DOI: 10.1046/j.1440-1622.1999.01490.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The results of regular intermittent self catheterization were compared with regular outpatient dilatation after endoscopic internal urethrotomy for urethral strictures. METHODS The records of patients who were treated for urethral stricture disease over a 4-year period from 1991 to 1994 were reviewed. They were either on regular urethral dilatation or were advised to carry out self calibration. A follow-up questionnaire was sent to them and they were asked to attend a review. Student's t-test and Proportion Test were used to find out if there was any significant difference between the two groups. RESULTS There were 78 patients who were on self calibration and 49 patients on regular urethral dilatation. There was no significant difference between the two groups regarding the duration of follow-up (21.5 and 23.7 months, respectively); the length of stricture (1.5 and 1.7 cm, respectively); and complications (two and four, respectively). However, patients on self calibration had narrower strictures (4.8 and 5.7 F) and a significantly lower restricture rate (5 and 16%). The current urinary stream was compared to the immediate postoperative stream. This showed that a higher number of patients in the dilatation group were voiding at less than 25% of their immediate postoperative flow. People from high and low socio-economic groups were able to carry out self calibration satisfactorily. CONCLUSION Patients from high and low socio-economic groups found that self calibration resulted in a lower restricture rate and better stream when compared to regular urethral dilatation.
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Affiliation(s)
- J Gnanaraj
- Department of Urology, Christian Medical College and Hospital, Vellore, India.
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Affiliation(s)
- A Devasia
- Department of Urology, Christian Medical College and Hospital, Tamil Nadu, India
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Affiliation(s)
- J Gnanaraj
- Department of Urology, Christian Medical College & Hospital, Vellore, India
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Gnanaraj J, Devasia A, Gnanaraj L, Gopalakrishnan G, Kekre NS. Bladder drainage during ureterorenoscopy: a new method. Br J Urol 1996; 78:299. [PMID: 8813933 DOI: 10.1046/j.1464-410x.1996.16129.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- J Gnanaraj
- Department of Urology, Christian Medical College & Hospital, Vellore, India
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Affiliation(s)
- A Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil-Nadu, India
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Abstract
Metastatic choriocarcinoma of the kidney is a rare entity, and its primary presentation with hematuria and renal mass is even less common. Two cases are presented with a review of the literature.
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Affiliation(s)
- A Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, India
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Devasia A, Gopalakrishnan G. Atraumatic cannulation of the vas for per-operative vasography. Br J Urol 1993; 72:989-90. [PMID: 8306184 DOI: 10.1111/j.1464-410x.1993.tb16328.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- A Devasia
- Department of Urology, Christian Medical College and Hospital, Vellore, India
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Jesudason SR, Devasia A, Mathen VI, Bhaktaviziam A, Khanduri P. The pattern of angiodysplasia of the gastrointestinal tract in a tropical country. Surg Gynecol Obstet 1985; 161:525-31. [PMID: 3877997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Angiodysplasia of the intestine was diagnosed by selective visceral angiography in ten of 30 patients from India with unexplained recurrent hemorrhage of the gastrointestinal tract. In contrast with the reports from the western literature, most of the instances involved the small intestine and occurred in the third decade of life.
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