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Nerli RB, Ghagane SC, Shadab R, Patil S, Mungarwadi A, Dixit NS. Neoadjuvant Chemotherapy Followed by Cystectomy: a Single-Center Experience. Indian J Surg Oncol 2023; 14:481-486. [PMID: 37324300 PMCID: PMC10267044 DOI: 10.1007/s13193-021-01386-6] [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] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022] Open
Abstract
Nearly 50% of patients with muscle-invasive bladder cancer treated with cystectomy alone will progress to metastatic disease. Surgery alone is not a sufficient therapy in a large number of patients with invasive bladder cancer. Systemic therapy with cisplatin-based chemotherapy has been shown to provide response rates in several bladder cancer studies. There have been multiple randomized controlled studies undertaken to define further the effectiveness of neoadjuvant cisplatin-based chemotherapy in advance of cystectomy. In this study, we have retrospectively reviewed our series of patients who underwent neoadjuvant chemotherapy followed by radical cystectomy for muscle-invasive disease. Between Jan 2005 and Dec 2019, 72 patients underwent radical cystectomy following neoadjuvant chemotherapy over a 15-year period. The data was retrospectively collected and analyzed. The median age was 59.84 ± 8.967 years (range, 43 to 74), and the ratio of male to female patients was 5:1. Of the 72 patients, 14 (19.44%) completed all the three cycles, 52 (72.22%) completed at least two cycles, and the remaining 6 (8.33%) completed only one cycle of neoadjuvant chemotherapy. A total of 36 (50%) patients died during the follow-up period. The mean and median survival of the patients was 84.85 ± 4.25 months and 91.0 ± 5.83 months respectively. Neoadjuvant MVAC should be offered to patients with locally advanced bladder cancer and who are candidates for radical cystectomy. It is safe and effective in patients with adequate renal function. The patients need to be carefully monitored for chemotherapy-induced toxic effects, and appropriate intervention is necessary in the event of severe adverse effects.
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Affiliation(s)
- R. B. Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010 India
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 India
| | - Shridhar C. Ghagane
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010 India
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 India
| | - Rangrez Shadab
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010 India
| | - Shivagouda Patil
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010 India
| | - Amit Mungarwadi
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010 India
| | - Neeraj S. Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 India
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Nerli R, Kalloli M, Rangrez S, Ghagane SC, Vinchurkar K, Shreya S, Thakur ML. Diagnosis of Oral Cancers by Targeting VPAC Receptors: Preliminary Report. Asian Pac J Cancer Prev 2023; 24:1711-1715. [PMID: 37247292 PMCID: PMC10495900 DOI: 10.31557/apjcp.2023.24.5.1711] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/20/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Oral cancer is a major health problem. The study of exfoliative cytology material helps in the differentiation of premalignant and malignant alterations of oral lesions. The objective of this study was to assess the feasibility of detecting oral cancer by targeting genomic VPAC (combined vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide) receptors expressed on malignant oral cancer cells. PATIENTS & METHODS All patients with suspected oral cavity cancers/lesions formed the study group. The samples from the oral cavity lesion or suspicious area were collected with a cytology brush. The harvested material was examined for malignant cells by 1. the standard PAP stain and 2. targeting the VPAC receptors on the cell surface using a fluorescent microscope. Similarly, malignant cells were identified from cells shed in oral gargles. RESULTS A total of 60 patients with oral lesions were included in the study. The histopathological diagnosis was squamous cell carcinoma in 30 of these. The VPAC receptor positivity both on the brush cytology staining as well oral gargle staining was more sensitive than the brush cytology PAP staining. The accuracy of the various techniques was as follows, brush cytology PAP staining at 86.67%, brush cytology VPAC staining at 91.67% and oral gargle VPAC staining at 95%. CONCLUSIONS This preliminary study validates our belief that malignant cells in the saliva can be identified by targeting the VPAC receptors. The test is simple, easy, non-invasive and reliable in the detection of oral cancers.
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Affiliation(s)
- Rajendra Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, India.
| | - Mahesh Kalloli
- Department of Surgical-Oncology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, India.
| | - Shadab Rangrez
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, India.
| | - Shridhar C Ghagane
- Department of Biotechnology, KAHER‟s Dr. Prabhakar Kore Basic Science Research Center, III Floor, V. K. Institute of Dental Sciences Campus, Nehru Nagar, Belagavi, India.
| | - Kumar Vinchurkar
- Department of Surgical-Oncology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, India.
| | - Shreya Shreya
- Urinary Biomarkers Research Centre, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, India.
| | - Madhukar L Thakur
- Departments of Urology, Radiology, Thomas Jefferson University, Philadelphia, PA, USA 6The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, PA, USA.
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Shadab R, Nerli RB, Bidi SR, Ghagane SC. Risk Factors for Bladder Cancer: Results of a Survey of Hospital Patients. J Cancer Allied Spec 2023; 9:485. [PMID: 37197001 PMCID: PMC10187602 DOI: 10.37029/jcas.v9i1.485] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/30/2022] [Indexed: 05/19/2023]
Abstract
Introduction Several risk factors have been identified in the occurrence of bladder cancer. These include genetic and hereditary factors, smoking and tobacco use, increased body mass index, occupational exposure to certain chemicals and dyes, medical conditions such as chronic cystitis and infectious diseases such as schistosomiasis. This study aimed to evaluate risk factors in patients with bladder cancer. Materials and Methods All patients presenting to the uro-oncology department of the hospital with imaging and histology confirmed bladder cancer were included in the study. Age- and gender-matched patients presenting to the department of urology with benign disorders were prospectively included as controls. All the study subjects and the controls completed a self-administered structured questionnaire. Results Seventy-two (67.3%) of the participants with bladder cancer were males. The mean age of participants with bladder cancer was 59.24 ± 16.28 years. Most participants with bladder cancer worked as farmers (35.5%) or industrial workers (24.3%). Recent history of recurrent urinary tract infections was seen in 85 (79.4%) of the participants with bladder cancer and 32 (30.8%) of controls. Diabetes mellitus was more common among participants with bladder cancer. A significant number of participants with bladder cancer used tobacco and smoked compared to controls. Conclusions This study highlights numerous potential biological and epidemiological factors that may act as a risk factors for bladder cancer. These factors could explain the gender differences observed in the incidence of bladder cancer. In addition, the study indicates the intense risk of tobacco products and smoking on the incidence of bladder cancer.
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Affiliation(s)
- Rangrez Shadab
- Department of Urology, JN Medical College, and Urinary Biomarkers Research Centre, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - R. B. Nerli
- Department of Urology, JN Medical College, and Urinary Biomarkers Research Centre, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
- Correspondence: R. B. Nerli, Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Belagavi, Karnataka, India. E-mail:
| | - Saziya R. Bidi
- Department of Urology, JN Medical College, and Urinary Biomarkers Research Centre, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Shridhar C. Ghagane
- Department of Biotechnology, Kaher’s Dr. Prabhakar Kore Basic Science Research Center, V. K. Institute of Dental Sciences Campus, Nehru Nagar, Belagavi, India
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Patel P, Prabha V, Verneker RR, Nerli RB, Patel T, Ghagane SC. Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study. Indian J Urol 2023; 39:33-38. [PMID: 36824103 PMCID: PMC9942221 DOI: 10.4103/iju.iju_190_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/15/2022] [Accepted: 12/16/2022] [Indexed: 02/25/2023] Open
Abstract
Introduction The most common reason for constructing an arteriovenous fistula (AVF) is chronic kidney disease. Various factors are associated with nonmaturation or failure of AVF, which can be evaluated using color Doppler/duplex ultrasound (DUS). We carried out this study to evaluate the role of pre- and postoperative DUS for the prediction of outcomes of wrist radiocephalic (RC) AVF. Methods In our prospective observational study, dialysis-dependent patients between 20 and 70 years of age undergoing primary RC-AVF from May 2019 to July 2020 were included. All patients underwent pre- and postoperative DUS examination after obtaining consent. Results Among 104 participants, 87 (83.7%) were male and 17 (16.3%) were female. Successful maturation was seen in 68 (65.4%) participants, whereas 90 (86.53%) had functional maturation. Radial artery diameter (RAD) ≥1.6 mm, cephalic vein diameter (CVD) ≥2.0 mm, vein distensibility (VD) ≥0.5 mm, and peak systolic velocity (PSV) RAD ≥30 cm/s were associated with higher successful maturation of AVF with statistically significant results (P < 0.05). RAD ≥1.6 mm, CVD ≥2.0 mm, VD ≥0.5 mm, and PSV RAD ≥30 cm/s were related to a greater probability of RC-AVF maturation. Among them, VD and PSV-RA were the most influencing factors predicting RC-AVF successful maturation. Conclusions If we consider the rule of six for AVF maturation, then the results will be much less than the actual fistulas which are dialyzable with adequate blood flow as per functional maturation criteria. Thus, more randomized studies are needed to define maturation criteria for the Indian population and to identify the effect of papaverine on successful AVF maturation.
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Affiliation(s)
- Priyeshkumar Patel
- Department of General Surgery, Shree Krishna Hospital, Bhaikaka University, Karamsad, India
| | - Vikram Prabha
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed to be University), Belagavi, Karnataka, India
| | - Ritesh R. Verneker
- Department of Nephrology, JN Medical College, KLE Academy of Higher Education and Research (Deemed to be University), Belagavi, Karnataka, India
| | - Rajendra B. Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed to be University), Belagavi, Karnataka, India
| | - Taral Patel
- Department of Paediatrics, M. K. Shah Medical College, Ahmedabad, Gujarat, India
| | - Shridhar C. Ghagane
- Department of Urology, KLE Academy of Higher Education and Research (Deemed to be University), Belagavi, Karnataka, India
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Nerli RB, Ghagane SC, Rangrez SS, Chandra S, Thakur ML, Gomella L. Author Reply Re: Nerli RB, Ghagane SC, Rangrez S, Chandra S, Thakur ML, Gomella L. Detection of bladder cancer using voided urine sample and by targeting genomic VPAC receptors. Indian J Urol 2021;37:345-9. Indian J Urol 2022; 38:78-79. [PMID: 35136304 PMCID: PMC8796771 DOI: 10.4103/iju.iju_462_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rajendra B. Nerli
- Department of Urology, JN Medical College, Belagavi, Karnataka, India,Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India,E-mail:
| | - Shridhar C. Ghagane
- Department of Urology, JN Medical College, Belagavi, Karnataka, India,Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | | | - Shreya Chandra
- Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Madhukar L. Thakur
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA,Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA,The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Leonard Gomella
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA,The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, PA, USA
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Sharma M, Nerli RB, Nutalapati SH, Ghagane SC. Hypoehoic lesions on Transrectal Ultrasound and its correlation to Gleason grade in the diagnosis of Clinically Significant Prostate Cancer: A Prospective Study. South Asian J Cancer 2021; 10:155-160. [PMID: 34938677 PMCID: PMC8687870 DOI: 10.1055/s-0041-1731906] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context
The importance of hypoechoic lesions on transrectal ultrasound (TRUS) merits re-assessment in the present era of widespread prostate-specific antigen (PSA) testing.
Aims
We aimed to investigate the predictive accuracy of hypoechoic lesions on TRUS of prostate in the diagnosis of prostate cancer and to examine the association of hypoechoic lesions with the aggressiveness of prostate cancer.
Settings and Design
This prospective study was conducted in a tertiary care center in South India from November 2017 to December 2019.
Methods and Material
We included 151 patients undergoing TRUS-guided 12-core prostate biopsy in view of raised serum PSA with or without suspicious digital rectal examination (DRE) findings in the study. Age, DRE findings, serum PSA level, TRUS findings, and histopathology reports were documented. These were compared between patients with and without hypoechoic lesions on TRUS.
Statistical Analysis Used
The statistical analysis for this study was performed using SPSS v20.0 software.
Results
Among 151 men, prostate cancer was diagnosed in 68 (45.03%) with mean age at presentation 69.81 ± 6.49 years. Fifty-eight cases (38.41%) had hypoechoic lesion on TRUS and the cancer detection rate (68.96%) amongst this group was significantly higher than in those without hypoechoic lesion (
p
<0.0001). Patients with hypoechoic lesion were more likely to have higher grade cancer. Abnormal DRE findings and hypoechoic lesion on TRUS were independent predictors of a clinically significant cancer (
p
<0.05).
Conclusion
Hypoechoic lesion on TRUS can be considered as an indicator of clinically significant prostate cancer.
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Affiliation(s)
- Manas Sharma
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Sree Harsha Nutalapati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
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Sharma M, Nerli RB, Ghagane SC. Urologic oncology during the COVID-19 pandemic. J Emerg Pract Trauma 2021. [DOI: 10.34172/jept.2021.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The COVID-19 pandemic will have numerous consequences in the management of patients with genitourinary cancers. As we are struggling to best exploit our limited health-care resources in managing COVID-19 infected patients, we need to rethink our approach to provide the best medical care for cancer patients in the time of this global crisis. There is a need for a decision-making algorithm which takes into account the age, presenting symptoms, comorbid illnesses, access to health-care services, and availability of qualified health-care personnel. We must provide support, a clear and comprehensible information along with essential care to the patients seeking medical opinion during a time of this unforeseen global health crisis. In this mini review we have made an attempt to prioritize the necessity of intervention in urological oncology patients as per various national and international guidelines. This approach should be tailored as per locally available health-care resources and the burden of COVID-19 infected cases in that region.
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Affiliation(s)
- Manas Sharma
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
| | - Rajendra B. Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
| | - Shridhar C. Ghagane
- Urinary Biomarkers Research Centre, Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi-590010, Karnataka, India
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Nerli RB, Ghagane SC, Rangrez S, Chandra S, Thakur ML, Gomella L. Detection of bladder cancer using voided urine sample and by targeting genomic VPAC receptors. Indian J Urol 2021; 37:345-349. [PMID: 34759527 PMCID: PMC8555562 DOI: 10.4103/iju.iju_132_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/12/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Cells exfoliated into urine from the bladder can help to diagnose the cancer. The objective of this study was to validate the hypothesis that bladder cancer could be detected noninvasively by a simple and reliable assay targeting genomic VPAC (combined vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide family of cell surface receptors) receptors expressed on the malignant bladder cancer cells shed in the voided urine. Methods: Patients ≥18 years of age with either imaging (ultrasonography/computed tomography [CT])-confirmed bladder tumors or those who have been previously treated for nonmuscle invasive bladder tumors and were visiting the department for check cystoscopy, formed the study group. Freshly voided urine sample was collected from these patients and sent for conventional cytology examination, 5-aminolevulinic acid (ALA) fluorescent urine cytology, and for positivity of VPAC receptors. Results: A total of 103 patients were prospectively included in the study. Of these, 65 patients (Group I) presented with image-diagnosed (ultrasonography and/or CT) bladder cancer. The remaining 38 patients (Group II) were previously diagnosed cases of nonmuscle invasive bladder cancer and presented for follow-up and check cystoscopy. The sensitivity for VPAC receptor positivity was 89.23% compared to conventional cytology (63.07%) and 5-ALA fluorescent urine cytology (87.69%). The specificity of VPAC receptor positivity was 100% compared to conventional cytology (100%) and 5-ALA-induced fluorescent cytology (90.47%). Conclusions: Our preliminary study shows encouraging results with VPAC receptor positivity studies, which has a high sensitivity when compared to the conventional cytology.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Karnataka, India.,Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Karnataka, India.,Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Shadab Rangrez
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Karnataka, India
| | - Shreya Chandra
- Division of Urologic-Oncology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Madhukar L Thakur
- Department of Urology and Radiology, Thomas Jefferson University, Philadelphia, PA, USA.,Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.,The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Leonard Gomella
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.,The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, PA, USA
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Nerli RB, Ghagane SC, Bidi SR, Thakur ML, Gomella L. Voided urine test to diagnose prostate cancer: Preliminary report. Cytojournal 2021; 18:26. [PMID: 34754324 PMCID: PMC8571200 DOI: 10.25259/cytojournal_76_2020] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/28/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Prostate cancer (PCa) is a common malignancy affecting elderly male. At present, PCa is estimated using serum prostate-specific antigen (PSA). Prostate biopsy remains the gold standard to confirm the diagnosis of PCa. In this preliminary study, we have assessed the feasibility of detecting PCa using voided urine by targeting the genomic vasoactive intestinal peptide receptor (VPAC) expressed on malignant PCa cells. Material and Methods Patients ≥40 years old, with no lower urinary tract symptoms (LUTS) and serum PSA levels of <1.6 ng/mL formed the control group and patients ≥40 years old, with LUTS and serum PSA >2.6 ng/ mL formed the study group. Patients were advised to give the first 50 mL of voided urine sample for the detection of malignant markers by targeting the VPAC. The results of histopathological studies were then compared to the results of urine biomarker. Results The study revealed absence of malignant markers in 75 patients (control group). In the study group, all the 33 patients with adenocarcinoma were positive for malignant markers in the biomarker study and absence of malignant markers in the 32 patients with benign histology. The results of the biomarker studies and histopathology were consistent with each other. Conclusion This preliminary study validates our belief that patients with PCa do shed malignant cells in the urine which can be identified by targeting the VPAC. The investigation is easy and our data appear to be highly encouraging and further serve as a simple, reliable, and a non-invasive tool in the detection of PCa.
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Affiliation(s)
- R B Nerli
- Department of Urology, Division of Urologic-Oncology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Belagavi, Karnataka, India.,Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and M.R.C, Belagavi, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, Division of Urologic-Oncology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Belagavi, Karnataka, India.,Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and M.R.C, Belagavi, Karnataka, India
| | - Saziya R Bidi
- Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and M.R.C, Belagavi, Karnataka, India
| | - Madhukar L Thakur
- Department of Urology, Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.,Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Leonard Gomella
- Department of Urology, Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.,Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.,The Sidney Kimmel Cancer Centre, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Shadab R, Nerli RB, Saziya BR, Ghagane SC, Shreya C. 5-ALA-Induced Fluorescent Cytology in the Diagnosis of Bladder Cancer-a Preliminary Report. Indian J Surg Oncol 2021; 12:415-420. [PMID: 34295088 DOI: 10.1007/s13193-021-01340-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/29/2021] [Indexed: 11/26/2022] Open
Abstract
5-Aminolevulinic acid (ALA)-induced fluorescence cystoscopy has established itself in the detection of flat and/or small lesions. This is explained by the simple fact that there is increased uptake of ALA, altered activity of certain enzymes, and altered intracellular redistribution and storage of protoporphyrin IX (PPIX) in the malignant cells. Intracellular PPIX allows red fluorescence detection. In this preliminary study, the efficacy of 5-ALA-induced fluorescent urine cytology was compared with conventional cytology in the diagnosis of bladder tumours. In this prospective study, patients ≥18 years of age admitted to the department of urology with non-malignant conditions formed the controls and patients ≥18 years of age with imaging confirmed bladder tumours formed the study group. Freshly voided urine sample was collected from these patients and divided into two samples of 50 cc each. One of these samples was sent in for conventional cytology examination, whereas the other sample was sent in for 5-ALA fluorescent photo dynamic diagnosis. Conventional cytology and 5-ALA-induced fluorescent cytology were evaluated by the same pathologist. A total of 100 patients were included in the study of which 75 patients were controls and the remaining 25 were patients with bladder tumours. The sensitivity of conventional cytology and 5-ALA-induced fluorescent cytology was 64% and 100% respectively, whereas the specificity was 96% and 98.67% respectively. The sensitivity of conventional cytology was 61.19% in low-grade cancers as compared to 75% in high-grade cancers, whereas the sensitivity was 100% with 5-ALA-induced fluorescent cytology both in low- as well as high-grade cancers. Our study shows that 5-ALA-induced fluorescent cytology is highly sensitive test to diagnose bladder cancer and shows a significant difference especially in low-grade bladder cancer when compared to conventional cytology.
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Affiliation(s)
- Rangrez Shadab
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, Karnataka 590010 India
| | - Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, Karnataka 590010 India
| | - Bidi R Saziya
- Urinary Biomarkers Research Centre, Division of Urologic-Oncology, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, Karnataka 590010 India
| | - S C Ghagane
- Urinary Biomarkers Research Centre, Division of Urologic-Oncology, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, Karnataka 590010 India
| | - Chandra Shreya
- Urinary Biomarkers Research Centre, Division of Urologic-Oncology, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, Karnataka 590010 India
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11
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B. Nerli R, B. Nerli R, Chandra S, Adhikari P, C. Ghagane S, Patil S. Hypospadias in Twins. Surg Case Rep 2021. [DOI: 10.31487/j.scr.2021.03.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hypospadias is one of the most common birth defects among male children. Many associated risks for hypospadias have been reported like family history, older maternal age, nulliparity, high pre-pregnancy body mass index of mother, hypertension or preeclampsia, multiple gestations, low birth weight, and small for gestational age. In literature twinning as a risk factor has been consistently shown to be associated with hypospadias. We report a 2-year-old male child (one of the twins) who presented with proximal microphallic hypospadias.
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12
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B. Nerli R, Gupta P, B. Nerli R, C. Ghagane S, Patil S, Chandra S. Intravesical Explosion Resulting in Bladder Rupture During Transurethral Resection of Prostate: A Case Report. Surg Case Rep 2021. [DOI: 10.31487/j.scr.2021.03.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Transurethral resection of prostate (TURP) is one of the most common surgeries in urology. Intravesical explosion during transurethral resection is an extremely rare event. It usually leads to bladder rupture, which can be either extra-or intra-peritoneal requiring urgent laparotomy. We report a case of intravesical blast in a 70-year-old male undergoing TURP.
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13
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B. Nerli R, B. Nerli R, Patel P, C. Ghagane S, Patil S, Sanikop A, Chandra S. Renal Cell Carcinoma with Level II Inferior Vena Cava Thrombi: Operative Steps. Surg Case Rep 2021. [DOI: 10.31487/j.scr.2021.03.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The incidence of venous tumor thrombi extension to the inferior vena cava (IVC) in renal cell carcinoma (RCC) has markedly increased recently due to the advances in diagnostic modalities. Such vascular invasion implies a heightened biologic behaviour and a surgical challenge during the course of treatment. Several studies have examined the prognostic significance of the level of venous extension. It has been suggested recently that long-term survival may be significantly better in patients with renal vein involvement than IVC involvement. We describe the operative steps in the treatment of level II IVC thrombus in this report.
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14
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B. Nerli R, Patel P, B. Nerli R, C. Ghagane S, Gupta P, Patil S, S. Dixit N. Two Piece Inflatable Penile Prosthesis Surgery: Operative Steps. Surg Case Rep 2021. [DOI: 10.31487/j.scr.2021.03.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The placement of a penile prosthesis has been considered the most reliable and effective treatment for erectile dysfunction in men with failed medical treatment. The 2-piece system eliminates a need for separate reservoir making the surgery easy for the treating surgeon/urologist. We report the use of this two-piece prosthesis in a 50-year-old patient with erectile dysfunction and describe the surgical steps of the same.
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15
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Nerli RB, Sharma M, Patel P, Ghagane SC, Patil SD, Gupta P, Hiremath MB, Dixit NS. Modified Inguinal Lymph Node Dissection in Groin-Negative Patients of Penile Cancer: Our Experience. Indian J Surg Oncol 2021; 12:229-234. [PMID: 33814858 DOI: 10.1007/s13193-021-01285-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/27/2021] [Indexed: 02/05/2023] Open
Abstract
Cancer of the penis is an important health problem in India, causing significant morbidity. Involvement of locoregional lymph nodes is the most significant prognostic factor for patients with penile cancer. In this study, we reviewed clinical data of all patients who underwent modified inguinal lymph node dissection as a means to diagnose micro-metastasis in inguinal lymph nodes, and analysed the outcomes. We retrospectively reviewed the hospital clinical charts of patients treated for carcinoma of the penis. Inguinal and distant metastases were assessed by physical examination, ultrasound imaging of the inguinal region, computed tomography of the abdomen and pelvis and a chest radiograph. Patients with clinically negative inguinal lymph nodes underwent modified lymph node dissection (mILND) both to diagnose and stage the disease. Complications occurring during a 30-day period after surgery were defined as early and thereafter as late complications. A total of 40 patients with a mean age of 52.27±13.10 (range 25-73) years underwent mILND. Wedge biopsy from the primary lesion had revealed intermediate-risk disease in 22 (55%) patients and high-risk disease in 18 (45%) patients. Histopathological examination of the primary penile lesion revealed a pT1 lesion in 32 patients and a pT2 lesion in the remaining 8 patients. Fourteen (35%) of the 40 patients showed micro-metastases in the inguinal lymph nodes on frozen sections. The mean follow-up in these patients was 56.6±18.09 months. There were no instances of local or systemic recurrences seen in 38 (95%) patients within 5 years. Superficial lymph node dissection and where facilities are available DSLNB remain the standard of care in the management of patients with clinically groin-negative (cN0) intermediate- and high-risk groups. Modified inguinal lymph node dissection would be a safe and appropriate alternative to this in all centres that do not have access to newer modalities like DSLNB, video-endoscopic (VEIL) or robotic-assisted techniques.
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Affiliation(s)
- R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, Karnataka 590010 India
| | - Manas Sharma
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, Karnataka 590010 India
| | - Priyeshkumar Patel
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, Karnataka 590010 India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 India
| | - Shashank D Patil
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, Karnataka 590010 India
| | - Pulkit Gupta
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, Karnataka 590010 India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka India
| | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 India
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16
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Nerli RB, Sharma M, Gupta P, Adhikari P, Bidi S, Ghagane SC. Therapeutic ureteroscopy for urolithiasis in children younger than 60 months of age. Pediatr Surg Int 2021; 37:145-150. [PMID: 33170363 DOI: 10.1007/s00383-020-04777-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The management of urinary tract calculi has evolved dramatically in children with the development of smaller and more durable endoscopic equipment. The indications for therapeutic ureteroscopy in children have significantly expanded with the availability of smaller caliber endoscopes and Holmium:YAG laser. In this paper, we review our experience of the management of urolithiasis and report outcomes of therapeutic ureterorenoscopy (URS) in children younger than 60 months. METHODS We retrospectively reviewed the inpatient, outpatient records, and imaging data of our hospital, of all children ≤ 60 months of age undergoing URS for the treatment of urinary stones. RESULTS During the study period; 77 children, mostly male (70.1%) presenting with a single calculus and a mean age of 28.97 ± 2.44 months underwent therapeutic URS. A majority of children (71.4%) had lower or mid-ureteric calculi. Pre URS double J (DJ) stenting was necessary for 21 (27.2%) children. A total of 24 (31.1%) children needed ureteric dilatation before the ureteroscopy. Post URS DJ stenting was necessary in 41 (53.2%) children. Stents were retrieved within 10 days of the procedure. Stone clearance rate following a single-stage URS procedure was 94.8%, and 4 (5.2%) children needed additional shockwave lithotripsy (SWL) to achieve stone clearance. Overall complication rate including hematuria and fever was 12.9% (10 patients). CONCLUSION Therapeutic ureterorenoscopy in the management of ureteric and selective renal pelvic calculi is safe and effective. It can be considered as the first-line therapy in young children.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010, Karnataka, India.
| | - Manas Sharma
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Pulkit Gupta
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Priyabrata Adhikari
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Saziya Bidi
- Department of Urology, Urinary Biomarker Research Centre, KLES Kidney Foundation, KLES Dr, Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, Urinary Biomarker Research Centre, KLES Kidney Foundation, KLES Dr, Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, Karnataka, India
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17
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Nerli RB, Sanikop AC, Sharma M, Ghagane SC. COVID-19 pandemic: A challenge to a child with cancer. Pediatr Blood Cancer 2020; 67:e28512. [PMID: 32633877 PMCID: PMC7361136 DOI: 10.1002/pbc.28512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/31/2022]
Affiliation(s)
- R. B. Nerli
- Department of UrologyJN Medical CollegeKLE Academy of Higher Education & ResearchBelagaviKarnatakaIndia
| | - Adarsh C. Sanikop
- Department of PathologyJN Medical CollegeKLE Academy of Higher Education & ResearchBelagaviKarnatakaIndia
| | - Manas Sharma
- Department of UrologyJN Medical CollegeKLE Academy of Higher Education & ResearchBelagaviKarnatakaIndia
| | - Shridhar C. Ghagane
- Urinary Biomarkers Research CentreDepartment of UrologyKLES Dr Prabhakar Kore Hospital & Medical Research CentreBelagaviKarnatakaIndia
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18
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Nerli RB, Kadeli V, Deole S, Mishra A, Patil S, Ghagane SC, Hiremath MB, Dixit NS. Postpercutaneous Nephrolithotomy Ureteropelvic Junction Obstruction. J Endourol Case Rep 2020; 6:13-15. [PMID: 32775665 DOI: 10.1089/cren.2019.0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Percutaneous endoscopic renal surgery such as percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for patients with large and/or complex renal calculi. However, a unique set of complications can occur with this surgical approach that may involve the targeted kidney and surrounding structures. Renal collecting system obstruction after PCNL is rare, but may result from ureteral avulsion, stricture formation, transient mucosal edema, blood clot, or infundibular stenosis. Impaction of stone and trauma during PCNL could induce stricture formation and obstruction. Use of proper percutaneous and endoscopic techniques and instruments will help to reduce the chances of developing such strictures and obstruction.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, Belagavi, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & M.R.C, Belagavi, India
| | - Vishal Kadeli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, Belagavi, India
| | - Sushant Deole
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, Belagavi, India
| | - Aarushi Mishra
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, Belagavi, India
| | - Shivagouda Patil
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, Belagavi, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & M.R.C, Belagavi, India
| | | | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & M.R.C, Belagavi, India
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19
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Nutalapati S, Ghagane SC, Nerli RB, Jali MV, Dixit NS. Association of erectile dysfunction and type II diabetes mellitus at a tertiary care centre of south India. Diabetes Metab Syndr 2020; 14:649-653. [PMID: 32438327 DOI: 10.1016/j.dsx.2020.04.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Erectile Dysfunction (ED) is more common in diabetic men and, unfortunately, occurs at an earlier age in diabetic patients when compared with the general population. The study aims to evaluate the independent predictors of ED in adult men with type 2 diabetes mellitus (DM) at a tertiary care center of South India. METHODS A total of 720 men aged 30-70 years who had been diagnosed with type 2 DM were enrolled for the study from January 2017 to January 2020 from the outpatient diabetes clinic of the Hospital. All patients completed the abridged version of the International Index of Erectile Function (IIEF-5) questionnaire. RESULTS The mean age of the patients was (58.4 ± 7.8 years). 68.6% of subjects had varying degrees of erectile dysfunction, of which 54.6% had moderate to severe ED. 55.8% had poor glycemic control (HbA1c ≥ 7%). Subjects with ED had a longer duration of DM than those without ED (mean DM duration was 8.1 ± 4.9 years versus 4.4 ± 3.5 years; p < 0.001). Longer duration of DM, poor glycemic control, hypertension, peripheral arterial disease, testosterone deficiency were all independent predictors ED (p < 0.05). CONCLUSIONS A high incidence of erectile dysfunction was observed in type 2 DM patients attending the diabetic clinic, and over half of the people affected were of moderate-to-severe in intensity. Poor glycemic control, testosterone deficiency, peripheral arterial disease were the modifiable risk factors for ED in diabetic subjects. At the same time, a longer duration of type 2 DM was noticed as a glaring non-modifiable risk factor, according to our study.
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Affiliation(s)
- Sreeharsha Nutalapati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Shridhar C Ghagane
- KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India; Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India.
| | - M V Jali
- KLE Academy of Higher Education and Research (Deemed to Be University), Nehru Nagar, Belagavi, 590010, India; KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - Neeraj S Dixit
- Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
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20
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Abstract
The current coronavirus pandemic forces us to realize the significance of the careful utilization of financial and health-care resources. At the same time, it is important to ensure the ability of urologists to function through this crisis to provide essential and emergency services. With regards to urological procedures, a triage of non-emergent operations is hence recommended considering various disease-related factors. Case conduct should also be categorized based on the up-to-date information of the evolving national, regional and local conditions of this pandemic, as marked variation in these conditions can lead to significant differences in decision-making. Over the coming weeks and months, we are bound to face an increasingly difficult task of treating Coronavirus disease 2019 (COVID-19) infected patients presenting with urological ailments. Instituting well-thought plans to perform the un-deferrable urological procedures and emergencies during this pandemic will go a long way in keeping the surgeons and health-care workers safe to perform essential duties.
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Affiliation(s)
- Manas Sharma
- Department of Urology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
| | - Shridhar C. Ghagane
- Urinary Biomarkers Research Centre, Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi-590010, Karnataka, India
| | - Shubhashree Muralidhar
- Department of General Surgery, Jawaharlal Nehru Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
| | - Shashank Patil
- Department of Urology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
| | - Naina R. Nerli
- University Law College & Department of Studies in Law, Bangalore University, Janana Bharati Banaglore, Karnataka, India
| | - Rajendra B. Nerli
- Department of Urology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi-590010, Karnataka, India
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21
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Nerli RB, Pathade A, Patil S, Kadeli V, Nutalpati S, Ghagane SC, Dixit NS, Hiremath MB. Percutaneous Nephrolithotomy in an Elderly Female with Severe Kyphoscoliosis: Modified Prone Position. J Endourol Case Rep 2020; 5:187-189. [PMID: 31967083 PMCID: PMC6916732 DOI: 10.1089/cren.2019.0110] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Percutaneous nephrolithotomy (PCNL) is one of the important options in the management of large (>2 cms) and complex renal calculi. Traditionally the prone position has been used to access the pelvicaliceal system as well as to remove renal calculi. Several modifications to this position have been suggested and reported by several urologists. We performed PCNL in an elderly female with a severe kyphoscoliosis by modifying the classical prone position.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belagavi, Karnataka, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Amey Pathade
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belagavi, Karnataka, India
| | - Shivagouda Patil
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belagavi, Karnataka, India
| | - Vishal Kadeli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belagavi, Karnataka, India
| | - Sreeharsha Nutalpati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belagavi, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Murigendra B Hiremath
- Department of Studies in Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
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22
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Nerli RB, Ghagane SC, Kadeli V, Nutalpati S, Mohan S, Hiremath MB. Bleeding angiomyolipoma mimiking a ruptured adrenal tumour. Urol Case Rep 2019; 28:101031. [PMID: 31641611 PMCID: PMC6796711 DOI: 10.1016/j.eucr.2019.101031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/26/2019] [Accepted: 09/29/2019] [Indexed: 11/18/2022] Open
Abstract
Angiomyolipoma is a benign neoplasm of the kidney, and is the most common renal tumour associated with haemorrhage. Risk of bleeding increases with the size of the angiomyolipoma. We report a case of spontaneous bleeding from an upper polar renal angiomyolipoma mimicking a spontaneous adrenal bleed from a pheochromocytoma.
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Affiliation(s)
- R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, Karnataka, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, Karnataka, India
| | - Vishal Kadeli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, Karnataka, India
| | - Shreeharsha Nutalpati
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, Karnataka, India
| | - Sham Mohan
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, Karnataka, India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
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23
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Nerli RB, Ghagane SC, Musale A, Mungarwadi A, Dixit NS, Hiremath MB. High grade renal trauma in a child with rupture bladder and fracture pelvic bones. Urol Case Rep 2019; 24:100850. [PMID: 31211061 PMCID: PMC6562282 DOI: 10.1016/j.eucr.2019.100850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/13/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- R B Nerli
- Department of Urology, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Abhijit Musale
- Department of Urology, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, India
| | - Amit Mungarwadi
- Department of Urology, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, India
| | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
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24
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Nerli RB, Ghagane SC, Dixit NS, Hiremath MB. Traumatic rupture of hydronephrosis secondary to UPJ obstruction in a child: A case report. Urol Case Rep 2018; 23:27-28. [PMID: 30534524 PMCID: PMC6279991 DOI: 10.1016/j.eucr.2018.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 01/10/2023] Open
Affiliation(s)
- R B Nerli
- Department of Urology, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi, 590010, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
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Nerli RB, Ghagane SC, Dixit NS, Hiremath MB. Urethral duplication in a child with VATER association. Urol Case Rep 2018; 23:29-31. [PMID: 30534525 PMCID: PMC6282190 DOI: 10.1016/j.eucr.2018.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education & Research, JNMC Campus, Belagavi, 590010, India.,KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, 590010, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - Neeraj S Dixit
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
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Ghagane SC, Puranik SI, Gan SH, Hiremath MB, Nerli RB, Ravishankar MV. Frontiers of monoclonal antibodies: Applications in medical practices. Hum Antibodies 2018; 26:135-142. [PMID: 29060935 DOI: 10.3233/hab-170331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
With the flourishing of innovation in drug discovery into a new era of personalized therapy, the use of monoclonal antibodies (mAbs) in the treatment of various ailments lies at the forefront. Major improvements in genetic sequencing and biomedical techniques as well as research into mAbs emphasize on determining new targets for advanced therapy while maximizing efficacy for clinical application. However, a balance has to be achieved concerning developing a target with low toxicity combined with high specificity and versatility, to allow a specific antibody to facilitate several biotic effects, ranging from neutralization of virus mechanisms to modulation of immune response and maintaining low global economic cost. Presently, there are approximately 30 mAbs' permitted for therapeutic use with many more being tested in clinical trials. Nevertheless, the heavy cost of mAbs' production, stowage and management as well as the subsequent hindrances to their development are outweighed by mAbs' clinical advantages. Compared to conventional drugs, since mAbs use as pharmacologic iotas have specific physical features and modes of action, they should be considered as a discrete therapeutic category. In this review, the history of mAb generation and the innovative technological applications of mAbs that has advanced in clinical practices is reviewed.
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Affiliation(s)
- Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi-590010, India.,Department of Biotechnology and Microbiology, Karnatak University, Dharwad-580003, India
| | - Sridevi I Puranik
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad-580003, India.,Department of Biotechnology, KLES R. L. Science Institute (Autonomous), Belagavi-590001, India
| | - Siew Hua Gan
- School of Medical Sciences, USM, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad-580003, India
| | - R B Nerli
- Department of Urology, KLE University's JN Medical College, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi-590010, India
| | - M V Ravishankar
- Department of Anatomy USM-KLE, IMP, JNMC Campus, Nehru Nagar, Belagavi, India
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Nerli RB, Ghagane SC, Ram P, Shimikore SS, Vinchurkar K, Hiremath MB. Bladder Invasion in Patients with Advanced Colorectal Carcinoma. Indian J Surg Oncol 2018; 9:547-551. [PMID: 30538386 DOI: 10.1007/s13193-018-0788-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 07/13/2018] [Indexed: 11/24/2022] Open
Abstract
Involvement of the bladder by colorectal cancer is sufficiently rare to be encountered by an individual surgeon on an infrequent basis. Extirpative procedures for advanced colorectal cancers can involve partial/total bladder resections. In patients without evidence of distant metastatic disease, a reasonable therapeutic effect can be expected when negative surgical margins are obtained. The decision to perform a bladder-sparing procedure or a total pelvic exenteration (TPE) will be based on the extent of the primary lesion as well as patient characteristics. In this study, we report our experience in the management of operable locally advanced colorectal carcinomas involving the urinary bladder. We retrospectively reviewed the hospital records of all patients with advanced colorectal cancer invading the urinary bladder. The age, gender, clinical presentation, physical examination findings, and imaging records were noted. Colonoscopy reports and images were noted and biopsy findings recorded. Similarly, cystoscopy findings and biopsy reports were noted and analyzed. Eight (88%) patients had a primary sigmoid tumor and one (11%) had primary rectal tumor. The clinical staging of the primary tumor was T3 in three (33%) and T4 in six (66%). A biopsy taken during cystoscopy confirmed the malignant lesion in all the nine patients. Four (44%) patients received neoadjuvant chemotherapy with 5-fluorouracil. Eight (88%) patients underwent bladder-sparing resection and the remaining one underwent total pelvic exenteration with ileal conduit for urinary drainage. The mean overall survival was 44 months. The wide spectrum of possible bladder involvement by colorectal cancer requires individual patient-specific and disease-specific approaches. En bloc bladder resection for adherent or invading colorectal cancers achieves good local control and prognosis. The potential for cure in completely excised, node-negative tumors is good. Bladder reconstruction is achievable in most patients.
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Affiliation(s)
- Rajendra B Nerli
- 1Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, 590010 Karnataka India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010 Karnataka India
| | - Prasanna Ram
- 1Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, 590010 Karnataka India
| | - S S Shimikore
- 3Department of Surgery, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, 590010 Karnataka India
| | - Kumar Vinchurkar
- 4Department of Surgical Oncology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, 590010 Karnataka India
| | - Murigendra B Hiremath
- 5Department of Biotechnology and Microbiology, Karnatak University, Dharwad, 580003 Karnataka India
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Nerli RB, Kadeli V, Mulimani N, Ghagane SC. Endovascular Management in a Case of Recurrent Bleed Following Transurethral Resection of the Prostate. The Arab Journal of Interventional Radiology 2018. [DOI: 10.4103/ajir.ajir_28_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Transurethral resection of prostate (TURP) remains the gold standard surgical therapy for symptomatic benign prostatic enlargement, with reported International Prostate Symptom Score reduction of up to 70%. However, as many as 20% of patients can have significant complications including sexual dysfunction, perioperative bleeding requiring blood transfusion, and incontinence. Intractable hematuria from the prostate can be life-threatening, and its management remains a difficult clinical problem. Prostate artery embolization (PAE) is occasionally indicated in such patients when all other measures have failed. PAE has been used to treat benign prostatic hyperplasia; however, literature related to its use for bleeding following TURP remains limited. We report a case of an elderly male who presented with recurrent episodes of hematuria following TURP and was successfully treated by endovascular management.
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Affiliation(s)
- R. B. Nerli
- KLES Kidney Foundation KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, India
| | - Vishal Kadeli
- Department of Urology, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Belagavi, India
| | - Naveen Mulimani
- Department of Interventional Radiology, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, India
| | - Shridhar C. Ghagane
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi, India
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Nerli Rajendra B, Pingale ND, Ghagane SC, Wagh AT, Malur PR. A Series of Primary Signet Ring Cell Carcinoma of the Urinary Bladder. Indian J Surg Oncol 2017; 8:443-446. [DOI: 10.1007/s13193-017-0664-z] [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] [Received: 09/26/2016] [Accepted: 04/24/2017] [Indexed: 11/29/2022] Open
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Ghagane SC, Nerli RB, Hiremath MB, Wagh AT, Magdum PV. Incidence of prostate cancer at a single tertiary care center in North Karnataka. Indian J Cancer 2017; 53:429-431. [PMID: 28244476 DOI: 10.4103/0019-509x.200671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Prostate cancer (PC) remains one of the most common cancers affecting men today. Thus, understanding the prevalence, disease characteristics, and changing demographics of Indian PC patients has emerged as an important aspect of study. AIMS We aimed to present the case series of PC patients from single tertiary care center in North Karnataka. SETTINGS AND DESIGN The study designed over a period of 8 years from 2007 to 2015 was conducted in the Department of Urology, KLES Dr. Prabhakar Kore Hospital, Belagavi, Karnataka. MATERIALS AND METHODS A total of 471 newly diagnosed patients with PC from 2007 to 2015 were included in the study. Sociodemographic, clinical characteristics, radiological and histopathological findings of all patients were collected and analyzed for the risk of PC. STATISTICAL ANALYSIS USED The statistical analysis used in this study was IBM SPSS Statistics software Inc., version 20.0. RESULTS A total of 471 patients were diagnosed with PC, the mean age at presentation was 70 years, and mean prostate-specific antigen (PSA) level was 37.71 ng/mL. Digital rectal examination (DRE) was abnormal in 87.5% of 471 cases. Significant correlation was observed between PSA level and DRE (P = 0.0005), correlation of PSA and Gleason's score was P = 0.0006, and histopathological results showed high risk in patients (P = 0.0001). CONCLUSIONS This is the first hospital-based study of PC incidence with clinical and histopathological features. PC remains an important public health problem with increasing incidence and significant burden on health-care resources in India.
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Affiliation(s)
- S C Ghagane
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - R B Nerli
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital, Belagavi, Karnataka, India
| | - M B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - A T Wagh
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital, Belagavi, Karnataka, India
| | - P V Magdum
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital, Belagavi, Karnataka, India
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Ghagane SC, Puranik SI, Kumbar VM, Nerli RB, Jalalpure SS, Hiremath MB, Neelagund S, Aladakatti R. In vitro antioxidant and anticancer activity of Leea indica leaf extracts on human prostate cancer cell lines. Integr Med Res 2017; 6:79-87. [PMID: 28462147 PMCID: PMC5395687 DOI: 10.1016/j.imr.2017.01.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/06/2017] [Accepted: 01/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background To determine the phytochemical constituents, antioxidant, and anticancer activities of Leea indica leaf extracts on DU-145 and PC-3 human prostate cancer cell lines. Methods Leaf sample was subjected to Soxhlet extraction method with increasing polarity of solvents, namely, chloroform, ethyl acetate, methanol, ethanol, and aqueous. Phytochemical screening was done using different biochemical tests. Quantitative analysis for phenol was determined by Folin–Ciocalteu reagent method. The antioxidant activity was tested using 2,2-diphenyl-1-picrylhydrazyl, ferric ion reducing power assay, and phosphomolybdenum assay. In vitro anticancer activity on DU-145 and PC-3 human prostate cancer cell lines was evaluated by (3-(4, 5-dimethyl thiazole-2yl)-2, 5-diphenyl tetrazolium bromide) MTT assay. Results Phytochemical screening confirmed the presence of phyto-constituents like alkaloids, flavonoids, glycosides, phenols, lignins, saponins, sterols, tannins, anthraquinone, and reducing sugar. Methanol and ethanol extracts exhibited higher phenolic content as compare to aqueous extract. Antioxidant capacities were shown highest in methanol and ethanol extracts based on the test performed. The methanol and ethanol leaf extracts were found to be selectively cytotoxic in vitro to (DU-145 and PC-3) prostate cancer cell lines with IC50 values 529.44 ± 42.07 μg/mL and 677.11 ± 37.01 μg/mL for DU-145 and 547.55 ± 33.52 μg/mL and 631.99 ± 50.24 μg/mL for PC-3 respectively, while it had no cytotoxic effect on normal mice embryo fibroblast cells. Conclusion The results indicate that Leea indica was a promising antioxidant and anticancer agent for DU-145 and PC-3 human prostate cancer cell lines. However, further studies are needed to conclude its therapeutic use.
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Affiliation(s)
- Shridhar C. Ghagane
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, India
| | - Sridevi I. Puranik
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, India
- Department of Biotechnology, K.L.E’s R. L. Science Institute, (Autonomous), Belagavi, India
| | - Vijay M. Kumbar
- Dr. Prabhakar Kore Basic Science Research Center, KLE University, Belagavi, India
| | - Rajendra B. Nerli
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Center, Belagavi, India
| | - Sunil S. Jalalpure
- Dr. Prabhakar Kore Basic Science Research Center, KLE University, Belagavi, India
- KLE University’s College of Pharmacy, Belagavi, India
| | - Murigendra B. Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, India
- Corresponding author. Department of Biotechnology and Microbiology, Karnatak University, Dharwad, 580003 Karnataka, India.
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Ghagane SC, Puranik SI, Nerli RB, Hiremath MB. Evaluation of in vitro antioxidant and anticancer activity of Allophylus cobbe leaf extracts on DU-145 and PC-3 human prostate cancer cell lines. Cytotechnology 2016; 69:167-177. [PMID: 27990568 DOI: 10.1007/s10616-016-0048-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 11/22/2016] [Indexed: 11/28/2022] Open
Abstract
Allophylus cobbe (L.) Raeusch. belonging to the family Sapindaceae, is a commonly distributed small shrub in Western Ghats of India previously reported for its traditional medicinal properties. It is used for the treatment of various ailments. The present study is aimed at investigating preliminary phytochemicals, inducing the determination of the total phenolic contents, antioxidant assays and anticancer activity of A. cobbe leaf extracts on (DU-145) and (PC-3) cell lines. Preliminary phytochemical screening showed a broad spectrum of secondary metabolites. Highest amount of phenolic content was present in aqueous extract (91.96 ± 0.61 mg/g GAE) and it also proved to have the most potent antioxidant activity at a concentration of 100 mg/ml (64.71 ± 0.15%). IC50 value was (431.10 ± 15.05 µg/mL) for DU-145 and (362.08 ± 24.17 µg/mL) for PC-3 cell lines while the standard drug paclitaxel showed an IC50 value of 0.3 µM/mL. Morphological changes was observed in cancerous cells undergoing apoptosis in human prostate cancer cell lines (DU-145 and PC-3) while the extract showed no cytotoxicity towards normal cells (MEF-L929). It can be concluded that the tested extracts holds significant antioxidant and anticancer activities. However further investigation on lead compounds of A. cobbe will enable its therapeutic use.
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Affiliation(s)
- Shridhar C Ghagane
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - Shridevi I Puranik
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India.,Department of Biotechnology, K.L.E'S R. L. Science Institute, (Autonomous), Belagavi, Karnataka, India
| | - Rajendra B Nerli
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
| | - Murigendra B Hiremath
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India.
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Nerli RB, Magdum PV, Ghagane SC, Hiremath MB, Reddy M. Umbilical only access laparoscopic pyeloplasty in children: Preliminary report. Afr J Paediatr Surg 2016; 13:36-40. [PMID: 27251522 PMCID: PMC4955455 DOI: 10.4103/0189-6725.181705] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Over the past three decades, laparoscopic surgery has become a well-established alternative to open surgery in the management of ureteropelvic junction (UPJ) obstruction. Currently, several efforts are being made, aimed at further reducing the morbidity associated with conventional laparoscopy. We report our experience with modified umbilical port laparoscopic pyeloplasty in children. MATERIALS AND METHODS Children presenting with hydronephrosis secondary to UPJ obstruction formed the study group. A 5 mm endoscopic port was placed on the inferior umbilical crease. The two 3 mm instruments were introduced through puncture sites created a few mm superior and lateral to the endoscopic port, under vision. Total operating time, the time taken for insertion of double pigtail catheter, time taken for pyeloplasty anastomosis and complications were noted. RESULTS During the study period, 16 children underwent modified umbilical only access laparoscopic pyeloplasty. The total operating time and the time for insertion of double pigtail catheter were significantly more in our earlier half of cases. CONCLUSIONS Modified umbilical port laparoscopic pyeloplasty reduces the morbidity associated with conventional multiport laparoscopy without the need of expensive multichannel cannulas, curved laparoscopic instruments and longer laparoscopic endoscopes. Though crossing instruments are a factor which prolongs the duration of surgery, it does not hinder complex suturing needed during pyeloplasty.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India
| | - Prasad V Magdum
- Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India
| | - Shridhar C Ghagane
- PG Department of Studies in Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - Murigendra B Hiremath
- PG Department of Studies in Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - Mallikarjuna Reddy
- Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India
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