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Introduction: The International Continence Society recommends zeroing of transducers to the atmospheric pressure for invasive urodynamics. The range of abdominal pressure relative to atmospheric pressure is well‐known in adults but has not been described in children. This prospective observational study was carried out to establish baseline abdominal in children. Materials and Methods: Prospective, multicenter, observational study of 100 children aged 0‐18 years undergoing invasive urodynamics using water‐filled systems. Initial resting abdominal pressure, intravesical pressure and detrusor pressure were recorded in supine, sitting, and standing position (as age‐ and diagnosis‐appropriate). This data was analyzed using SPSS 20.0.0 with regard to age, gender, height, weight, body mass index, and underlying diagnosis (classified as neurogenic or non‐neurogenic). Nonparametric tests were used (2‐sided p < 0.05, significant). Results: Initial resting abdominal pressure (inter‐quartile range) in children was between 5 and 15 cmH2O in the supine, 13−20 cmH2O in the sitting, and 15−21 cmH2O in the standing position. These pressures were not consistently influenced by age, gender, height, weight or underlying diagnosis. The initial resting detrusor pressure was noted to be 0−4 cmH2O without any difference based on posture. Limitations include use of two‐tube technique, relatively small number of subjects across each age group, wide range of underlying diagnoses and need for manual smoothing of some traces. Conclusion: This study defines initial resting abdominal pressure at urodynamics in children and notes that, as with adults, it is possible to define widely applicable ranges regardless of individual characteristics. These pressures appear lower than those noted historically in adults. [ABSTRACT FROM AUTHOR]

Byline: Gyanendra. Sharma, Arabind. Panda, Anshu. Sharma Introduction: Differentiating nonobstructive from obstructive dilatation of the kidney is a clinical dilemma in prenatally detected hydronephrosis. Many radionuclide renogram parameters have been [...]

Byline: Arabind. Panda Burnout was initially described by Freudenberger in 1980 in his book. 'Burn-out: The High Cost of High Achievement'as the 'extinction of motivation or incentive.'[1] It has been [...]

Byline: Sanjay. Kulkarni, Amilal. Bhat, Hardev. Bhatyal, Gyanendra. Sharma, Deepak. Dubey, Nikhil. Khattar, Arabind. Panda, Anujdeep. Dangi, Vikram. Batra, Pankaj. Joshi These guidelines have been drafted by the Urological Society [...]

Byline: Arabind. Panda Delay in Radical Prostatectomy Is not Associated With Adverse Oncological Outcomes This was a retrospective review of 128,062 men with intermediate- and high-risk prostate cancers from 2010 [...]

Byline: Shanmugasundaram. Rajaian, Murugavaithianathan. Pragatheeswarane, Arabind. Panda Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. Prompt diagnosis and timely repair are essential for successful management [...]

Byline: Arabind. Panda It is the proverbial elephant in the room; everyone sees it, no one talks about it. Health care in India is in crisis. For more than a [...]

Byline: Arabind. Panda Urological Oncology The risk of overall and differential 30 days mortality (TDM) after nephrectomy was retrospectively audited in 21,380 patients in the British association of urological surgeons [...]

Byline: Arabind. Panda Multiparametric Magnetic Resonance Imaging: Transrectal Ultrasound-guided Fusion Biopsy Prostate cancer in India presents late and remains an important cause of death in men. Bansal et al.[sup][1] present [...]

Byline: Arabind. Panda Prostate cancer remains a leading cause of death among men. It has always been a heterogeneous disease, the natural history being widely variable. There are many who, [...]

Byline: Vivek. Venkatramani, Arun Jacob. George, J. Chandrasingh, Arabind. Panda, Antony. Devasia A 12-year-old boy presented with poor flow and recurrent urinary tract infections following hypospadias repair at the age [...]

Byline: Arabind. Panda Tissue engineering using stem cells has captured the imagination of the public and physicians alike. Like a Phoenix regenerating from its ashes, the thought of regenerating an [...]

Byline: Vivek. Venkatramani, Arabind. Panda, Nitin. Kekre Introduction: Our aim was to determine the correlation of platelet count with stage and grade of renal cell carcinoma (RCC) and to determine [...]

Byline: Nitin. Abrol, Arabind. Panda, Nitin. Kekre, Antony. Devasia Stone formation in the urinary tract is a common phenomenon with associated morbidity. The exact physicochemical factors responsible for stone formation [...]

Introduction: Differentiating nonobstructive from obstructive dilatation of the kidney is a clinical dilemma in prenatally detected hydronephrosis. Many radionuclide renogram parameters have been used to differentiate obstructed from non-obstructed units, including cortical transit time (CTT). We evaluate the role of CTT in identifying obstruction through a systematic review. Methods: A literature search of the MEDLINE, MEDLINE In-Process, and MEDLINE Epub Ahead of Print, EMBASE, Google scholar, Pub Med, and Cochrane Library was done using key words -- radionuclide renogram, CTT, parenchymal transit time, cortical transit, renography to identify articles on the subject. The identified articles were assessed for appropriateness and reviewed. Results: The initial search yielded a total of 1583 articles, after adding the articles from references and applying the inclusion and exclusion criteria a total of 28 articles were selected. CTT showed good inter observer agreement in identifying obstruction. The use of CTT as a single parameter for determining the need for surgery and to identify those kidneys which will have functional improvement after surgery has been evaluated and has been found to be useful. CTT is best used in conjunction with ultrasonography to make clinical decisions. Conclusion: The commonly used visual method of estimating the CTT, is a promising parameter for the evaluation of prenatally detected pelviureteric junction obstruction. Further well-designed multicenter prospective studies are needed to establish it as the most specific parameter to differentiate obstructive from nonobstructive dilatation of the pelvicalyceal system. [ABSTRACT FROM AUTHOR]

Byline: Nitin. Abrol, Arabind. Panda, Nitin. Kekre The incidence of varicocele in the general population is up to 15%. It is estimated that the prevalence of pain with varicoceles is [...]

Byline: Arabind. Panda The concept of radical prostatectomy for metastatic prostate cancer is interesting. The rationale of debulking in metastatic cancer is derived from the experience in gastric and ovarian [...]

Byline: Arabind. Panda, Nitin. Kekre Copy from one, its plagiarism; copy from two, its research. - Wilson Mizner (1876-1933) US screenwriter Last summer during a visit to a school in [...]

Byline: Arabind. Panda, Santosh. Kumar, Nitin. Kekre Summary Stephenson et al . have followed a cohort of 6,398 patients who underwent radical prostatectomy (RP) for localized prostate cancer over a [...]

Byline: Arabind. Panda The format of urological training in India has changed little since its inception. The dogma of tradition has perhaps failed to consider the paradigm shifts in the [...]

Byline: Arabind. Panda, L. Dorairajan, Santosh. Kumar Evidence-based medicine requires use of the best available evidence for optimal patient care. Increasingly scarce resources and escalating demands on time have led [...]

Introduction: To evaluate factors affecting a trial without catheter (TWOC) after acute urinary retention due to benign prostatic hyperplasia (BPH), and define the subset of patients unlikely to benefit from a TWOC. Methods: A TWOC was performed in 36 patients (mean age 67 years) with first episode of acute urinary retention from BPH after 3 days of catheterization. Initial international prostate symptom score( IPSS), volume of urine drained after catheterization (VD), prostate size by transrectal ultrasound (PS), intravesical protrusion (IVPr) of the prostate and detrusor volume were recorded. Results: TWOC was successful in 11 (30.5%) patients and 25 (69.5%) failed. Discriminant analysis was done to assess predictive factors. IVPr, PS and VD were found to contribute significantly (Wilks lamba, ë = 0.025) towards predicting outcome of TWOC. A prediction model, using cut off values, was derived using receiver operating characteristic curves (ROC). A cut off value of 8.2 mm for IVPr detected failures with a specificity of 87% and successes with a sensitivity of 64% ; area under ROC (AUROC) of 0.8. Cut off values of 38.5 ml for PS (specificity 82%, sensitivity 72%, AUROC =0.77) and 625 ml for VD (specificity 92%, sensitivity 55%, AUROC = 0.76) could be derived. Conclusions: IVPr, PS and VD can predict failure of TWOC. IVPr was the most important factor. In patients with an IVPr > 8.2mm or PS > 38.5 ml or a VD > 625 ml proceeding directly for surgery without a TWOC may be beneficial. [ABSTRACT FROM AUTHOR]

Introduction: Recent surgery and invasive procedures like subclavian puncture in the last 10 days are relative contraindications to the use of Streptokinase. We report our experience in a case who underwent PCN and who had to be administered Streptokinase thrombolysis following post -- procedure acute myocardial infarction. Case Report: A 48 year old male with no prior cardiac co-morbidities presented to urology out-patient department with features suggestive of right pyonephrosis. An urgent ultrasound (US) showed hydroureteronephrosis of the right side subsequent to an obstructing ureteric calculus with moving internal echoes within suggestive of pyonephrosis. Right PCN was done under local anaesthesia under US guidance by a single puncture. On completion of the procedure, the patient sustained an extensive myocardial infarction. He was shifted to the intensive cardiac care unit and the patient was reviewed by the cardiologists. It was decided that he be thrombolysed and the same was carried out with Inj. Streptokinase 1.5 MU i.v infusion. There was no hematuria, PCN site bleed or hematoma formation and the patient achieved defervescence within 24 hrs. He was discharged after 5 days on medications for ischaemic heart disease with a plan for definitive treatment of the ureteric calculus at a later date. Discussion: The main complication of fibrinolytic therapy is bleeding. Recent surgery and vascular puncture procedures among others are considered to be contraindications to Streptokinase administration. No reference is made in the literature regarding administration of Streptokinase following PCN. In our opinion, an uncomplicated PCN procedure that is not actively bleeding from the puncture site can be given Streptokinase thrombolysis in life threatening situations as an extenuating measure. [ABSTRACT FROM AUTHOR]