An unusual presentation of anterior urethral valve in a child with diabetes mellitus

Anterior urethral valve (AUV) is identified to be a common source of congenital obstructive lesion of the anterior urethra. Up to 80% of children with AUVs develop bladder dysfunction, bladder instability, hyperreflexia, diminished compliance and capacity. We report a case of an unusual presentation of a child with AUV and diabetes mellitus

Augmentation gastrocystoplasty in a child with orofacial syndrome and dysfunctional voiding

We report the case of a child diagnosed with orofacial syndrome with dysfunctional voiding and elevated serum creatinine in whom augmentation gastrocystoplasty was performed to manage urinary incontinence.Keywords: augmentation gastrocystoplasty, dysfunctional voiding, orofacial syndrom

Genetic Polymorphism and Prostate Cancer: An Update

Genetic polymorphism and prostate cancer (PC) are the most pernicious and recurrently malignancy worldwide. It is the most dominating cause of cancer related casualty among men in the US. Asian countries are inflicted with PC at an alarming rate though still the prevalence of PC is lower than European and American men. Some of the genetic and environmental factors that might play a role in PC risk include: age genetic predilection, family history, race/ethnicity, lifestyle, and dietary habits and non-dietary environmental risk factors such as smoking. Socio-economic factors including economic, scholastic and intellectual factors do not, intrinsically seem to straight away influence the risk of acquiring PC. Other genetic changes that may support an increased risk of developing PC include HPC1, HPC2, HPCX, CAPB, ATM,s HOXB13 and mismatch repair genes. PC occurrence rates are highly variable. Almost all PC mortalities are due to metastatic disease, generally through tumors the progress to be hormone refractory or castrate resistant. PC, developing research has acknowledged a number of candidate genes and biological pathways associated with PC. Indirect pathways such as P13K/AKT signaling pathway is one of most well known alternate pathway in PC Vascular endothelial growth factor (VEGF) is widely known to be potent stimulator of angiogenesis. The over expression of EGFR in a very large majority of cases is accompanied by the succession of PC, implying that this may play a mechanistic role. Numerous occupational factors have been proposed to cause PC. Some of the risk factors include; farmers/agricultural workers, pesticides, shift work and flight personnel. PC treatment can be done through surgery, radical prostatectomy is the main type of surgery. Risks of injury are many – reactions to anesthesia, loss of blood, blood clumps in the legs/lungs, injury to surrounding organs, infection at the site of surgery and many more. The other treatments are hormone therapy, chemotherapy and radio therapy chemotherapy. Chemotherapeutic drugs are typically used one at a time for PC such as transurethral resection of prostate (TURP). Some of the chemotherapeutic drugs are Docetaxel, Cabazitaxel, Mitoxantrone and Estramustine. Among the score of biomarkers being studied, numerous markers and techniques deserve awareness and acceptability for both patients and urologists in clinical practice

Reproductive Toxicology: An Update

Human reproduction and development is a succession of symbiotic events. Nearly, at every point of this phenomenon found to be the principle target of one or more reproductive toxicants. Chemical agents, physical factors, as well as biological intruders can pose antagonistic effects on reproductive potential of an organism. The pathways are different viz., either damaging embryo and sometimes fetus or inducing mutation in a parent’s germ cell. The outcomes are declined fertility to impulsive abortion, functional discrepancies, developmental retardation, structural anomalies, etc. It is a now essential to establishing proper databases for reproductive and developmental toxicity chemicals, physical and biological factors including appropriate awareness among the society. Although many in vitro and in vivo toxicology studies are in pipeline which are independent studies but combination with other hazardous studies could give us an accurate numbers

Management of antenatally diagnosed hydronephrosis in a child presenting later with urinary tract infections: A case report

Preservation of renal function remains the main goal of follow-up of a child with antenatal hydronephrosis. The question remains as to how long we need to follow these children. Even after several decades, the indications and timing of surgery in a newborn with hydronephrosis are still debated. Herewith, we report the case of a 9-year-old male child who was diagnosed to have hydronephrosis on antenatal scans and was managed conservatively postnatally who presented after 9 years with recurrent urinary tract infections

Therapeutic Applications of Monoclonal Antibodies in Urologic-Oncology Management - An Update

The idea of utilizing immunotherapy for the treatment of cancers has been appealing to scientists and clinicians for over a several decades. Immunotherapy for cancers encompasses knowledge gained from a wide range of disciplines and has the potential to procure the ‘magic bullet’ for the treatment of cancer. Monoclonal antibody-based treatment of cancer has been recognized as one of the most successful therapeutic strategies for both hematologic malignancies and solid tumours in the last 20 years. The discovery of hybridoma technology in late 1975 and the development of chimeric, humanized, and human antibodies have increased the availability and utility of immunotherapy for the treatment of cancer. Metastatic or recurrent cancer continues to be the bane of the urological oncologist. Despite recent improvements in therapeutic management and outcomes for clinically localized disease overall survival rate in patients with the majority of metastatic and recurrent genitourinary malignancies remains relatively unchanged. By targeting tumours through specific or associated antigens, it is possible to selectively eliminate tumour cells and maintain an acceptable toxicity profile. Therapeutic antibodies that target immune cells are also being developed with the goal of breaking local tolerance and stimulating the patient’s anti-tumor immune response. As with other treatment modalities, immunotherapy is far from perfect and requires additional study to optimize clinical response and overcome therapeutic resistance. Modern advances in the field of immunotherapy hold the promise of providing the clinical urologist/oncologist with new tools to fight urological cancer. However, the literature on monoclonal antibody-based immunotherapy with a particular emphasis on target antigens, monoclonal antibody design and potential applications in the field of urology is limited. Hence, the present chapter focuses on the applications of Immunotherapy using monoclonal antibodies for urologic oncology settings such as prostate, bladder, renal, testicular and penile with a hope to highlight its clinical efficacy and also its mechanisms of action in each of these cancer types

Diagnosis of Oral Cancers by Targeting VPAC Receptors: Preliminary Report

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