Efficacy of value added foxtail millet therapeutic food in the management of diabetes and dyslipidamea in type 2 diabetic patients

Introduction: The dietary strategies aim at improving both diabetes control and cardiovascular risk factors is the use of low–glycemic index diets. Diet has been the sheet anchor in the management of diabetes. We studied the effect of increasing the intake of millet based diet in patients with type 2 diabetes mellitus. Methods: In a randomized, crossover study, we assigned 300 patients with type 2 diabetes mellitus to follow millet based  diabetic diet, each for 90 days: a diet containing moderate amounts of fiber similar to as recommended by the American Diabetes Association (ADA). The diet is being prepared in a research laboratory of NAIP of UAS Dharwad. We compared the effects of the millet based diet on glycemic control and plasma lipid concentrations. Fasting plasma total cholesterol and triglycerides were measured. Cholesterol in the low-density lipoprotein (LDL) fraction was estimated. Results: Compliance with the diets was excellent. The millet based diet lowered HbA1c (19.14%), fasting glucose (13.5 %), insulin (1.9%) concentrations, total cholesterol concentrations (13.25 %), triglyceride concentrations (13.51%), and very-low-density lipoprotein cholesterol concentrations by 4.5 percent in the patients with type 2 diabetes. However, the group did not differ for changes in body weight. Conclusions: A high intake of millet based dietary fiber, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes

Diabetes: (A report on the “New Frontiers in Diabetes†held at KLES Dr. Prabhakar Kore Hospital & MRC, Belgaum during 7-8 August 2010)

A report on the “New Frontiers in Diabetes†held at KLES Dr. Prabhakar Kore Hospital & MRC, Belgaum during 7-8 August 201

Preliminary experience with laparoscopic Foley′s YV plasty for ureteropelvic junction obstruction in children

Introduction: Laparoscopic dismembered pyeloplasty is an acceptable option for ureteropelvic junction (UPJ) obstruction in the paediatric population. We compared our results of laparoscopic dismembered and non-dismembered Foley′s YV pyeloplasty. Materials and Methods: Children presenting with hydronephrosis secondary to UPJ obstruction formed the study group. Foley′s YV plasty was planned whenever it was observed that a tension free dismembered pyeloplasty was not possible in spite of all possible manoeuvres. Children were followed up for urinary infection, and renogram was repeated after 3 months. Results: During the study period, 108 children (63 male and 45 female) with a mean age of 4.94 ± 2.78 years underwent laparoscopic dismembered pyeloplasty and the remaining 11 children (5 male and 6 female) with a mean age of 4.00 ± 1.776 years underwent laparoscopic Foley′s YV plasty. There were no major peri-operative complications noted and conversion to open was not necessary in any child. Renogram done at 3 months post-operatively showed good drainage and improvement of renal function. Conclusions: Laparoscopic Foley′s YV pyeloplasty is a safe and effective technique in appropriately selected cases of primary UPJ obstruction in children

Modified Cantwell-Ransley epispadias repair in children our experience

Introduction: We retrospectively evaluated our experience with modified Cantwell-Ransley epispadias repair at our center to determine the complications and long-term results. Materials and Methods: We retrospectively reviewed the case records of 43 male children with a mean age of 9.13 ± 1.94 years who underwent primary epispadias repair at our center. The results of epispadias repair were assessed by both physical and endoscopic examination. All children who were old enough to opine as well as all parents/guardians were interviewed during the follow-up visits. Results: Urethrocutaneous fistulae occurred in 17.85% (5/28) children of the classic bladder exstrophy group and in 13.33% (2/15) children with penopubic epispadias. Postoperative cystoscopy done 12 weeks after repair revealed a smooth urethral tube in 81.39% (35/43) of children. With the patient in a standing position, the penis was dangling downward or in a horizontal position in 88.37% (38) of children, 85% of the patients ≥18 years of age were satisfied with both the functional and cosmetic outcome, as assessed by short form 36 and 93.02% (40/43) of the patients were continent during the daytime with voided volumes of more than 200 ml. Conclusion: In our experience, Cantwell-Ransley repair creates a functionally and cosmetically acceptable penis and produces a reliably tubularized neourethra with acceptable complication rates

Laparoscopic Mitrofanoff continent catheterisable stoma in children with spina bifida

Background: In 1980, Mitrofanoff described the creation of an appendicovesicostomy for continent urinary diversion. This procedure greatly facilitates clean intermittent catheterisation in patients with neurogenic bladder. The purpose of our study was to determine the clinical efficacy of the laparoscopic Mitrofanoff catheterisable stoma for children and adolescents with spina bifida. Materials and Methods: Review of hospital records revealed that 11 children with spina bifida underwent a laparoscopic Mitrofanoff procedure with at least 1-year of follow-up. A four-port transperitoneal laparoscopic approach was used to create a Mitrofanoff appendicovesicostomy. The child was followed-up in the urology clinic at 6 weeks, 3 months, 6 months, 1-year, and then semiannually after that. Questionnaires were administered to determine, from the children′s perspective, the level of satisfaction with catheterisation and the psychosocial implications of catheterisation before and after the creation of the Mitrofanoff continent catheterisable stoma. Results: Of the 11 children, six were female, and five were male. The mean age at presentation to Paediatric urological services was 11 × 3.22 years. Overall the mean operative time was 144.09 × 17.00 min. Mean estimated blood loss was 37.36 × 11.44 cc. None of the cases needed conversion to open. Patient satisfaction with their catheterisation was measured at 2.18 × 0.98 preoperatively, Post-operatively, this improved to 4.27 × 0.46. Statistical analysis using paired t-test showed significance with P < 001. Conclusions: Laparoscopic Mitrofanoff catheterisable stoma is feasible in children with spina bifida and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis

Inflammatory pseudotumor of the bladder in a child

Inflammatory pseudotumors of the bladder are rare in children. We report here the case of an 11-year-old child who presented with lower urinary tract symptoms. Ultrasonography and computed tomography imaging of abdomen showed an intravesical mass/thickening arising from the right lateral wall. Biopsy of the lesion revealed a lesion that showed uniform elongated spindle cells within a background of myxoid stroma. The cells were loosely packed from a smooth muscle lesion, which had a densely packed cellular stroma. The child improved with a course of antibiotics and a repeat imaging showed disappearance of the lesion