Compare Outcomes Of Single Stage Vs Two Stage Urethroplasty For Panurethral Strictures Including Pre-Operative And Post-Operative Course

Aim: The aim of the present study was to compare outcomes of single stage vs two stage urethroplasty for panurethral strictures including pre-operative and post-operative course. Methods: The Observational study was conducted at Dr. D.Y. Patil Medical College and Research Centre, Pimpri for the period of 2 years. The study was conducted in 40 patients randomly dividing into two groups, 20 patients underwent single stage urethroplasty and 20 underwent two staged urethroplasty with or without buccal mucosal graft urethroplasty based on size of urethral plate. Results: In the present study, majority of the patients belonged to 41-50 years age group followed by 31-40 years age group and it was found that age groups were not statistically significant. Majority of the patients had Balanitis xerotica obliterans (LS) etiology followed by Post instrumentation/catheter and the results were not statistically significant. Majority of the patients had 13-15 cms length of stricture. In the present study, 12 and 16 were narrow external uretheral meatus in single and two stage respectively. In the two stage, Johanson’s urethroplasty procedure was done and in single stage, Kulkarni’s full length dorsal onlay BMG urethroplasty procedure was done. In single and two stage, Urethrocutaneous Fistula and Epididymo-orchitis complications were noted. In single stage, success was noted in 16 patients and in two stage, success was noted in 17 patients. Conclusion: The single stage repair in patients with LS had good results with less re-stricture rates. The use of BMG as a substitution in single stage repair had re-stricture rates compared to flaps substitution. The two-stage repair should be limited to complex urethral strictures, failed urethroplasty and obliterated urethral stricture urethral caliber is less than 6F

Environmentally Benign Protocol for the Synthesis of 1,2-dihydro-1-aryl naph- tho [1,2-e] [1,3] oxazine-3-one Derivatives

Abstract: 1,2-dihydro-1-aryl naphtho [1,2-e] [1,3] oxazine-3-one derivatives have been synthesized via one-pot condensation of aromatic aldehyde, β-naphthol and urea using cellulose sulfuric acid (CSA) as catalyst in solvent free condition under microwave irradiation. CSA has efficiently catalyzed the cyclocondensation and enhanced the product yields by reducing reaction time. The uniqueness of CSA is that it is isolable after the reaction and reusable

Does urodynamics study help in evaluation and prognosis of treatment in benign prostatic hyperplasia with diabetes mellitus?

Aims: The aim is to study the clinical significance of urodynamics study (UDS) in patients of benign prostatic hyperplasia (BPH), with and without diabetes mellitus (DM) and to predict the outcome of surgical depending on UDS findings. Materials and Methods: A total of 120 BPH patients were studied and divided into two groups, BPH with DM and without DM. Initial evaluation, diagnostic tests, and urodynamic examination were done in all patients, and results were statistically analyzed. Results: There was no significant difference of age and prostate volume in both groups (P > 0.05), but there was a significant increase in symptom score in patients of BPH associated with DM (P < 0.05). Bladder outlet obstruction (BOO) was found in majority of patients in our groups (96.66%) with good detrusor function. Out of 120 patients, 6 patients (2 patient in BPH group and 4 patients in BPH with DM group) had detrusor underactivity (DU). There was a significant difference in the International Prostate Symptom Score, quality of life, peak flow rate, and postvoid residual urine, pre- to post-operatively in each group (P < 0.05). Out of the 6 patients who had DU, 4 patients (1 patient in BPH group and 3 patients in BPH with DM group) showed improvement in their flow rate and symptom score. Conclusion: DM in cases of BPH patients is not the prominent factor in deciding surgical treatment. It is the severity of BOO which determines the treatment and its outcome. UDS is an invasive and costly test and does not appear to be mandatory in clinically significant BPH even if associated with DM

Contribution of rare inherited and de novo variants in 2,871 congenital heart disease probands

Congenital heart disease (CHD) is the leading cause of mortality from birth defects. Exome sequencing of a single cohort of 2,871 CHD probands including 2,645 parent-offspring trios implicated rare inherited mutations in 1.8%, including a recessive founder mutation in GDF1 accounting for ~5% of severe CHD in Ashkenazim, recessive genotypes in MYH6 accounting for ~11% of Shone complex, and dominant FLT4 mutations accounting for 2.3% of Tetralogy of Fallot. De novo mutations (DNMs) accounted for 8% of cases, including ~3% of isolated CHD patients and ~28% with both neurodevelopmental and extra-cardiac congenital anomalies. Seven genes surpassed thresholds for genome-wide significance and 12 genes not previously implicated in CHD had > 70% probability of being disease-related; DNMs in ~440 genes are inferred to contribute to CHD. There was striking overlap between genes with damaging DNMs in probands with CHD and autism

Contribution of rare inherited and de novo variants in 2,871 congenital heart disease probands.

Congenital heart disease (CHD) is the leading cause of mortality from birth defects. Here, exome sequencing of a single cohort of 2,871 CHD probands, including 2,645 parent-offspring trios, implicated rare inherited mutations in 1.8%, including a recessive founder mutation in GDF1 accounting for ∼5% of severe CHD in Ashkenazim, recessive genotypes in MYH6 accounting for ∼11% of Shone complex, and dominant FLT4 mutations accounting for 2.3% of Tetralogy of Fallot. De novo mutations (DNMs) accounted for 8% of cases, including ∼3% of isolated CHD patients and ∼28% with both neurodevelopmental and extra-cardiac congenital anomalies. Seven genes surpassed thresholds for genome-wide significance, and 12 genes not previously implicated in CHD had &gt;70% probability of being disease related. DNMs in ∼440 genes were inferred to contribute to CHD. Striking overlap between genes with damaging DNMs in probands with CHD and autism was also found

Exome sequencing identifies recurrent somatic RAC1 mutations in melanoma

We characterized the mutational landscape of melanoma, the form of skin cancer with the highest mortality rate, by sequencing the exomes of 147 melanomas. Sun-exposed melanomas had markedly more ultraviolet (UV)-like C>T somatic mutations compared to sun-shielded acral, mucosal and uveal melanomas. Among the newly identified cancer genes was PPP6C, encoding a serine/threonine phosphatase, which harbored mutations that clustered in the active site in 12% of sun-exposed melanomas, exclusively in tumors with mutations in BRAF or NRAS. Notably, we identified a recurrent UV-signature, an activating mutation in RAC1 in 9.2% of sun-exposed melanomas. This activating mutation, the third most frequent in our cohort of sun-exposed melanoma after those of BRAF and NRAS, changes Pro29 to serine (RAC1P29S) in the highly conserved switch I domain. Crystal structures, and biochemical and functional studies of RAC1P29S showed that the alteration releases the conformational restraint conferred by the conserved proline, causes an increased binding of the protein to downstream effectors, and promotes melanocyte proliferation and migration. These findings raise the possibility that pharmacological inhibition of downstream effectors of RAC1 signaling could be of therapeutic benefit