bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urodynamics in the evaluation of lower urinary tract symptoms in young adult men: A systematic review
Authors: Singh Gurpremjit , Mittal Ankur , Sinha Sanjay , Panwar Vikas Kumar , Bhadoria Ajeet Singh , Mandal Arup Kumar 
Published: August 2023

ABSTRACT

Introduction:
This review aims to systematically evaluate the available evidence on the different urodynamic diagnoses of lower urinary tract symptoms (LUTS) in young adult men aged 18–50 years and to summarize the various urodynamic parameters based on these diagnoses.

Methods:
This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement and the search was performed in PubMed, Embase, and Cochrane library from inception till September 2021. A total of 295 records were identified using a combination of keywords such as LUTS, urodynamics (UDS), and young males. The review was registered in PROSPERO (CRD42021214045).

Results:
All the ten studies, which were included in this analysis, categorised the patients into either of the four primary diagnoses after the UDS – primary bladder neck obstruction (PBNO), dysfunctional voiding, detrusor underactivity (DU), or detrusor overactivity. Five of these studies used the conventional UDS, and in the other five a video UDS was performed. The most common abnormality on the conventional UDS was DU with a pooled estimate of 0.24 (95% confidence interval [CI] - 0.104–0.463, I2-95.35, (τ2-1.07). The most common abnormality on the video UDS was PBNO with a pooled estimate of 0.49 (95% CI - 0.413–0.580, I2-66.59, 2-0.09). The point estimates of various UDS parameters were also recorded.

Conclusion:
A urodynamic diagnosis was possible in 79% and 98% of the young men who underwent a conventional UDS or a video UDS, respectively. However, the men subjected to the conventional UDS and the video UDS had significant differences in their primary urodynamic diagnostic label. These results will help to plan future trials for the evaluation and management of LUTS in young men.
Perioperative, oncological, and survival outcomes of robotic radical cystectomy with urinary diversion in females
Authors: Agarwal Varun V. , Thyavihally B. Yuvaraja , Waigankar Santosh Subhash , Dev Preetham , Pednekar Abhinav P. , Roy Diptiman , Athikari Nevitha , Hastak Meenal , Badlani Naresh , Pokharkar D. Harshwardhan , Ayyalasomayajula Nagaraja Sekhar , Khandekar Archan , Asari Ashish 
Published: August 2023

ABSTRACT

Introduction:
Robot-assisted radical cystectomy (RARC) is a standrad approach for surgical management of bladder cancer. Currently, most literature on RARC is in men, possibly due to the higher incidence of bladder cancer in males. We reviewed the perioperative, oncological and survival outcomes in 41 women who underwent RARC by a single surgeon at a tertiary health-care center.

Methods:
Out of 225 RARC and urinary diversion procedures performed from 2012 to 2020, a retrospective analysis of 41 women was performed. Baseline demographic and perioperative details, oncological data, and survival were recorded and analyzed. Kaplan–Meir analysis was done for survival outcomes and prognostic factors were assessed by log rank test.

Results:
Thirty-eight patients underwent intracorporeal urinary diversion, while three underwent extracorporeal diversion. One patient underwent organ preserving cystectomy. Clavien–Dindo 30-day postoperative complications were Grade I in 8 (19.5%), Grade II in 4 (9.8%), and Grade IIIa in 3 (7.3%) patients with no mortality. During the median follow-up of 34 months (range: 6–87 months), 7 patients died of disease recurrence. Five-year survival was 74% (95% confidence interval [CI]: 59–82) and 35% (95% CI: 10–91) in transitional cell carcinoma (TCC) and non-TCC group, respectively, with P = 0.04. There was no mortality in Stages 0 and 1 disease. Five-year survival was 78% in Stage 2 and 41% in Stage 3 and 4.

Conclusion:
Our study demonstrates acceptable clinical, perioperative, and oncological outcomes of robotic radical cystectomy in females, thus highlighting its safety and feasibility.
Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation
Authors: Patel Priyeshkumar , Prabha Vikram , Verneker Ritesh R. , Nerli Rajendra B. , Patel Taral , Ghagane Shridhar C. 
Published: August 2023

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.
Xanthogranulomatous epididymo-orchitis
Authors: Vijayvergiya Garima , Gulwani Hanni Vasudev , Ul Hasan Shariq 
Published: August 2023

ABSTRACT

Introduction:
Xanthogranulomatous inflammation is a rare nonneoplastic and chronic inflammatory process, characterized by proliferation of foamy macrophages resulting in damage and necrosis of the affected tissue. Involvement of the testis/epididymis by the disease is a rare event.

Methods:
A case series of four male patients diagnosed with xanthogranulomatous epididymitis/orchitis (XGEO) at our institute was reviewed. In addition, a systematic review of XGEO was carried out using PRISMA Guidelines 2020. Twenty-nine articles describing 38 patients of XGEO were included in the study.

Results:
XGEO usually has a subacute or chronic presentation and affects male individuals in the 5th or 6th decades of life. The disease is also known to occur in the pediatric age group. The patients present with swelling, tenderness, or pain in the scrotal region. Bilateral involvement has also been documented. Thirty patients were known to have one or more causal risk factors including diabetes mellitus (23.7%), spinal cord injury/neuropathic bladder (7.9%), prostatectomy (7.9%), trauma (4.1%), and transurethral resection of prostate procedure (4.1%). Complications observed were scrotal fistula, adhesions, and abscess formation. Radiological features reported are nonspecific and include heterogeneous echotexture, hypoechoic areas, and/or scrotal wall collections. Bacterial microorganisms isolated from the affected tissue demonstrated the presence of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Histological subtypes of XGEO are diffuse and focal. In the diffuse subtype, which is more common, there is extensive parenchymal destruction by inflammatory process accompanied by widespread ischemic necrosis.

Conclusion:
The mainstay of treatment in XGEO cases is surgical excision preferably orchidectomy. Conservative management has been attempted in young individuals and in patients with focal XGEO, but there is limited supporting evidence. We present data of four cases along with detailed systematic review of the disease examining its clinicopathological behavior and associated risk factors followed by operative approach.
Peri-operative antibiotic usage during endourological surgery: A multi-institutional, national-level, cross-sectional audit of prevalent practice pattern in India
Authors: Nayyar Rishi , Kumar Shritosh ,   Collaborative Working Group on Use of Antibiotics in Endourology
Published: August 2023

ABSTRACT

Introduction:
Antibiotic use during endourological procedures is often discordant from the reported guidelines, despite the potential risks of antibiotic resistance, adverse effects, and health-care costs. A nationwide audit was conducted, with the support of the Urological Society of India, to ascertain the current antibiotic prescription practices for the endourological procedures and the reasons associated with them.

Methods:
A multi-institutional, national-level, cross-sectional audit analyzing elective endourological procedures was performed. The data regarding the disease profile; risk factors for infectious complications; urine culture; pre-, per-, and post-operative antibiotic use; additional antibiotic use; and patient demographics were collected in a standardized pro forma. Reasons for prescribing antibiotics divergent from the guideline recommendations were also noted. Any infectious complication that necessitated the antibiotic use was also noted prospectively up to 1 month. All the data were entered into a single centralized and customized online portal on a real-time basis.

Results:
One thousand five hundred and thirty-eight cases were recruited from 20 hospitals. A single-dose prophylaxis was prescribed in only 319 (20.7%) of the cases, and the majority received a multi-day prophylaxis. A combination of two or more antibiotics was prescribed as the prophylaxis in 51% of the cases. One thousand three hundred and fifty-six (88.2%) cases were continued on a long-duration prophylaxis after the discharge, with 1191 (77.4%) receiving it for > 3 days. One thousand one hundred and sixty (75.4%) cases received a guideline-discordant prophylaxis solely on the basis of the surgeon’s or institution’s protocol, rather than any specific case based need. Ninety eight (6.4%) cases developed postoperative urinary tract infection.

Conclusions:
Multi-dose, combination and post-discharge antibiotic prophylaxis for endourological surgeries is highly prevalent in India. This audit highlights the huge potential to reduce such guideline-discordant overuse of antibiotics during the endourological procedures.
Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India
Authors: Budukh Atul Madhukar , Thakur Jarnail S. , Dora Tapas Kumar , Kadam Prithviraj R. , Bagal Sonali S. , Patel Kamalesh Kumar , Goel Alok K. , Sancheti Sankalp M. , Gulia Ashish R. , Chaturvedi Pankaj P. , Dikshit Rajesh P. , Badwe Rajendra A. 
Published: August 2023

ABSTRACT

Introduction:
There is a scarcity of population-based prostate cancer survival data in India. We assessed the population-based, overall survival of patients with prostate cancer from the Sangrur and Mansa cancer registries of the Punjab state, India.

Methods:
In the year 2013–2016, a total of 171 prostate cancer cases were registered in these two registries. Based on these registries, survival analysis was performed using the date of diagnosis as the starting date and the last follow-up date being December 31, 2021 or the date of death. Survival was calculated using STATA software. Relative survival was calculated using the Pohar Perme method.

Results:
Follow up was available for all the registered cases. Of the 171 cases, 41 (24%) were alive and 130 (76.0%) were dead. Of the prescribed treatments, 106 (62.7%) cases completed the treatment and 63 (37.3%) cases did not complete the treatment. Overall, 5-year age-standardized prostate cancer relative survival was 30.3%. Patients who completed the treatment had a 7.8 times higher 5-year relative survival (45.5%) compared to those who did not (5.8%). The difference between the two groups is statistically significant (hazard ratio 0.16, 95% confidence interval [0.10–0.27]).

Conclusion:
To improve survival, we need to raise awareness in the community and among primary physicians so that prostate cancer cases can reach the hospital early and should be treated effectively. The cancer center should develop the systems in their hospital so that there will be no hurdles to the patients in treatment completion. We found a low overall relative survival among patients of prostate cancer in these two registries. Patients who received treatment had a significantly higher survival.
An unusual, delayed, solitary manifestation of a penile lesion in chronic lymphocytic leukemia
Authors: Hamid Tariq Abdul , Elmekresh Amr , Bagheri Fariborz 
Published: August 2023

ABSTRACT
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the adult western population. It is characterized by the proliferation of mature but dysfunctional lymphocytes, primarily CD5+ B cells. It primarily affects the reticuloendothelial system in the majority of the cases, but can rarely manifest as extranodal and extramedullary lesions. One of the rare presentations is genitourinary cutaneous infiltration, and only a handful of cases of secondary metastases to the genitourinary skin, have been reported in the literature. The current report describes a patient with solitary lesion of CLL in the penis, manifesting almost two decades after the complete treatment of CLL.
Impact of diabetes and chronic kidney disease on active surveillance outcomes for small renal masses: A cohort study
Authors: Alcalá Nicolas E. , Futral Cameron D. , Miller Caroline A. , Sinks Alexander L. , Clark Peter E. , Roy Ornob P. 
Published: August 2023

ABSTRACT

Introduction:
The American Cancer Society estimates 79,000 individuals will be diagnosed with kidney cancer in 2022, most of which are initially found as small renal masses (SRMs). Proper management of SRM patients includes careful evaluation of risk factors such as medical comorbidities and renal function. To investigate the importance of these risk factors, we examined their effect on crossover to delayed intervention (DI) and overall survival (OS) in patients undergoing active surveillance (AS) for SRMs.

Methods:
This is an Institutional Review Board-approved retrospective analysis of AS patients presented at kidney tumor conferences with SRMs between 2007 and 2017. Univariable and multivariable logistic regression analyses were performed to determine how factors including estimated glomerular filtration rate (eGFR), diabetes, and chronic kidney disease are associated with DI and OS.

Results:
A total of 111 cases were reviewed. In general, AS patients were elderly and had significant comorbidities. On univariate analysis, intervention was more likely to occur in patients with a younger age (P = 0.01), better kidney function (P = 0.01), and higher tumor growth rates (GRs) (P = 0.02). Higher eGFR was associated with better survival (P = 0.03), while higher tumor GRs (P = 0.014), greater Charlson Comorbidity Index (P = 0.01), and larger tumors (P = 0.01) were associated with worse OS. Of the comorbidities, diabetes was found to be an independent predictor of worse OS (P = 0.01).

Conclusions:
Patient-level factors – such as diabetes and eGFR – are associated with the rate of DI and OS among SRM patients. Consideration of these factors may facilitate better AS protocols and improve patient outcomes for those with SRMs.
Prosthetics in urology
Authors: Cheriyan Abhilash 
Published: August 2023

ABSTRACT
The field of genitourinary prosthetics has evolved rapidly to become the standard of care for conditions such as incontinence and refractory erectile dysfunction. Its scope has expanded to encompass newer indications such as Peyronie's disease and gender-affirming surgeries. This review, based on the Urological Society of India's Best Essay Award 2022, aims to elaborate on the advances in the field of urological prosthetics in the past 20 years as well as to provide an insight into ongoing research and what one can expect to see in the next decade, particularly in the area of penile and testicular prosthetics as well as treatment of incontinence. A PubMed and patent search was performed to achieve these objectives. Future considerations include improving acceptance, reliability, making them more accessible for developing countries and improving training and education to improve outcomes.
YKL-40 tissue expression in lichen planus
Authors: Doss Reham W. , Rashed Laila A. , Abdellatif Mona E.A. 
Published: August 2023

Background
Lichen planus (LP) is an idiopathic chronic inflammatory disease of the skin, mucous membranes, and nails. The exact pathogenesis of LP is still unclear. Chitinase-3-like protein 1 (YKL-40) is one of the 18 glycosyl hydrolases, but lacks enzymatic activity. Recent studies have shown that YKL-40 is present at sites of inflammation and tissue remodeling, triggers immune responses, and attracts eosinophils and T cells.

Objective
To clarify a suggested role of YKL-40 in LP inflammation.

Patients and methods
This case–control study included 30 cutaneous LP patients and 30 healthy volunteers serving as controls. About 4-mm punch-skin biopsies were taken from skin lesions in LP patients and healthy skin from controls. Skin biopsies were examined for YKL-40 using PCR technique.

Results
The expression of YKL-40 in LP lesions (5.12±1.02 pg/ml) was significantly higher than their expression in control-tissue biopsies (1.02±0.05 pg/ml) (P<0.001). No significant relation was detected between the expression of YKL-40, type of LP, and the disease duration.

Conclusion
We can conclude that upregulation of YKL-40 could point to a possible role in the pathogenesis of LP.
Assessment of serum total antioxidant status and interleukin-6 in vitiligo patients
Authors: Habib Mohammed A. , Mahdi Mohammed S. , Ibrahim Mona A. 
Published: August 2023

Background
Vitiligo is an acquired pigmentary disease resulting from the loss of melanocytes. Multiple theories are suggested in the etiopathogenesis of vitiligo. Of these, autoimmune cytokine aberrations and oxidant–antioxidant imbalance are highly incriminated.

Objective
To study the serum level of total antioxidant status (TAS) and interleukin-6 (IL-6) in both active and stable vitiligo patients, and to correlate between these serum markers and between different disease characteristics.

Patients and methods
This case–control study was carried out on 25 vitiligo patients (15 with active and 10 stable vitiligo), and 25 age-matched and sex-matched healthy controls. Full history taking, general, and dermatological examination were done for all patients. Five milliliters of whole blood from all participants were collected, and TAS and IL-6 were measured by enzyme-linked immunosorbent assay.

Results
There was a highly significant difference between patients and controls regarding the TAS and IL-6 levels, with lower TAS levels and higher IL-6 levels among patients as compared with controls. Higher TAS levels were found among stable than active patients. A highly significant positive correlation was found between the duration of the last activity and TAS level, while a highly significant negative correlation was present between vitiligo disease activity score and TAS level among patients. No significant difference was found in IL-6 between active and stable patients. There was a highly significant negative correlation between TAS level and IL-6 level among all participants, while no significant correlation was found between TAS and IL-6 levels among patients.

Conclusion
Depressed TAS and elevated IL-6 levels may play a role in vitiligo pathogenesis. TAS levels are related to the disease activity and can be used as an activity marker to distinguish active from stable vitiligo patients.
Efficacy of combined use of mycophenolate mofetil and granulocyte-colony-stimulating factor in the treatment of patients with dystrophic epidermolysis bullosa
Authors: Eldarouti Mohammad , Nada Hanan R. , El-Komy Mohamed , Abdelhady Mohamed , Saadi Dina G. , Doss Sally S. , El Sayed Hagar , Mostafa Pakinam I.N. 
Published: August 2023

Back
ground Patients with dystrophic epidermolysis bullosa (DEB) experience various degrees of widespread recurrent skin blistering and erosions that characteristically heal with exuberant scarring and milia formation. DEB may lead to the development of skin cancers. Advances in understanding the pathogenesis of EB in the last decade have led to the development of several therapeutic strategies.

Objective
To investigate the effectiveness of the combined use of granulocyte-colony-stimulating factor (GCSF) and mycophenolate mofetil (MMF) in the treatment of DEB and to compare our results with those of the previous studies that used either GCSF alone or MMF alone.

Patients and methods
Fifty-one patients with DEB were enrolled into this study. They were clinically assessed for total body blisters and erosions (both count and size) and scored using the Birmingham scoring system.

Results
There were significant improvements (P<0.001) with the use of combined treatment which was superior to each treatment alone.

Conclusion
Subcutaneous GCSF combined with MMF was shown to be superior to the use of either MMF or GCSF alone, in decreasing the rate of blister formation and in wound healing in patients with DEB.
Empirical Analysis of Poverty in India Using Multidimensional Poverty Index
Authors: Varghese Jacob , Roy Sakhi 
Published: August 2023

Background:
This study has employed the multidimensional and flexible index that is the Multidimensional Poverty Index (MPI) in achieving the objective of this study.

Aims and Objectives:
This study intends to assess and quantify the poverty levels of India using MPI.

Materials and Methods:
This study has selected eight indicators across three dimensions – health, education and social capital, and standard of living – in the estimation and applied the MPI method of cross-dimensional cut off across the indicators.

Results:
Upon completion, this study showed that India faces multidimensional poverty with an MPI of 0.4328.

Conclusion:
Estimation of multidimensional poverty can be done by even health-care professionals/institutes, notwithstanding constraints of data availability, to be used for policy considerations.