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Espinet S, Corrin T, Baliunas D, Quilty L, Zawertailo L, Rizvi SJ, deRuiter W, Bonato S, De Luca V, Kennedy S, Selby P. Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:115. [PMID: 31092292 PMCID: PMC6518617 DOI: 10.1186/s13643-019-1028-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/15/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The lifetime risk of suicide in patients with substance use disorder is five to ten times the risk in the general population. Critically, up to 19% of patients continue to think about and attempt suicide even after accessing treatment. Therefore, suicidality represents a significant clinical concern in patients struggling with substance use that warrants careful investigation of the factors involved. While most previous research has relied on limited cross-sectional designs, a growing number of prospective studies are improving our understanding of the factors involved. However, a systematic study of these factors has not yet been conducted. METHODS The primary objective of this review and possible meta-analysis will be to identify key risk and protective factors for suicide ideation, attempt, and death in patients accessing substance use treatment, guided by current models of suicide. Secondary and tertiary objectives will be to obtain pooled effect sizes for the factors identified and to disaggregate factors for suicidality before and after treatment, and for suicidal thought versus action. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we will conduct an electronic search of the literature using the databases Embase, Medline, PsycINFO, and Web of Science. Two authors will independently screen studies based on pre-specified inclusion and exclusion criteria, extract relevant data, and assess study quality. Observational and randomized-controlled studies will be included, whereas case-studies and reviews will be excluded. We will extract data on risk and protective factors associated with suicide ideation, attempt (odds or risk ratios), and death (hazard ratio). Given sufficient data (> 5 studies), we will calculate pooled effects using comprehensive meta-analysis. DISCUSSION This systematic review will contribute to our knowledge of risk and protective factors for suicidality in patients before and after treatment. Understanding these factors will help define areas of research for further investigation to ultimately inform risk assessment and prevention strategies. SYSTEMATIC REVIEW REGISTRATION PROSPERO (reference number: CRD42018076260).
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Affiliation(s)
- S Espinet
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada.
| | - T Corrin
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada
| | - D Baliunas
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada
| | - L Quilty
- Department of Psychiatry, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Canada
| | - L Zawertailo
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada
| | - S J Rizvi
- Department of Psychiatry, Arthur Sommer Rotenberg Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - W deRuiter
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada
| | - S Bonato
- Department of Library Services, CAMH, Toronto, Canada
| | - V De Luca
- Department of Psychiatry, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Canada
| | - S Kennedy
- Department of Psychiatry, Arthur Sommer Rotenberg Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute and the Toronto Western Research Institute, University of Toronto, Toronto, Canada
| | - P Selby
- Addiction Program, Centre for Addiction and Mental Health, Nicotine Dependence Clinic, (CAMH), 175 College street, Toronto, ON, M5T 1P7, Canada
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Pal BC, Modi PR, Rizvi SJ, Chauhan R, Kumar S, Nagarajan R, Kaushal D, Kute VB, Trivedi HL. The Learning Curve of Pure Retroperitoneoscopic Donor Nephrectomy. Int J Organ Transplant Med 2017; 8:180-185. [PMID: 29321833 PMCID: PMC5756899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Retroperitoneoscopic donor nephrectomy (RDN) is a well-established modality for the procurement of kidneys for renal transplantation. However the learning curve of pure RDN is not yet defined. Defining the learning curve will help in proper mentorship of the new donor surgeons besides providing safety to the donors. OBJECTIVE To define the learning curve of pure RDN. METHODS We analyzed the prospectively collected data of 102 voluntary kidney donors who underwent RDN by a single surgeon between August 2012 and April 2015 at our center. The donors were classified into group A (1-34), group B (35-68), and group C (69-102) according to the chronological order of their surgery. Left RDN was performed in 28 (82%), 25 (74%), and 28 (82%) donors of group A, B, and C, respectively. Right RDN was performed in 6 (18%), 9 (26%), and 6 (18%) donors of group A, B, and C, respectively. The clinical data were analyzed for each group. RESULTS Statistically significant difference was observed for the mean operative time (p<0.01) and warm ischemia time (p<0.04). The operative time remained around 200 minutes after the initial 35 cases. CONCLUSION The learning curve of pure RDN was 35 cases, although the mastery requires more number of cases to be performed.
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Affiliation(s)
- B. C. Pal
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India,Correspondence: Bipin Chandra Pal, MS, M Ch, DNB, Professor of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre - Institute of Transplantation Sciences, Ahmadabad, Gujarat, India, 380016, Tel: +91-989-830-5890, E-mail:
| | - P. R. Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - S. J. Rizvi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - R. Chauhan
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - S. Kumar
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - R. Nagarajan
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - D. Kaushal
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - V. B. Kute
- Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016. Gujarat, India
| | - H. L. Trivedi
- Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016. Gujarat, India
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Orandi BJ, Kraus ES, Bagnasco SM, Van Arendonk KJ, Garonzik-Wang JM, Wickliffe C, Montgomery RA, Segev DL, Trivedi HL, Vanikar AV, Dave SD, Patel HV, Kute VB, Gumber MR, Rawal MN, Modi PR, Rizvi SJ, Sicard A, Ducreux S, Rabeyrin M, McGregor B, Badet L, Scoazec JY, Fremeau-Bacchi V, Morelon E, Dubois V, Thaunat O, Kiki E, Kainz A, Kozakowski N, Oberbauer R, Regele H, Bartel G, Boehmig GA, Mallamaci F, Tripepi R, Leonardis D, Mafrica A, Versace MC, Provenzano F, Tripepi G, Zoccali C. TRANSPLANTATION 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sharma S, Shah K, Santhosh BS, Rizvi SJ. Appendicocalicostomy: A case of mistaken identity. Indian J Urol 2014; 30:228-9. [PMID: 24744527 PMCID: PMC3989830 DOI: 10.4103/0970-1591.126915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Anatomical structures with similar appearance may at times be confused for each other. This situation can be compounded by lack of normal anatomical planes. We did ureterocalicostomy on a 32-year-female with secondary pelvi-ureteral junction obstruction. Post-operatively, it was discovered that she had a long appendix running parallel to ureter in retroperitoneum, which was misidentified as ureter and anastomosed to the lower pole of the kidney. She was re-explored, appendix was removed, ureter was identified and ureterocalicostomy was done. Patient is asymptomatic at 1 year follow-up.
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Affiliation(s)
- S Sharma
- Department of Urology and Renal Transplantation, Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre-Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - K Shah
- Department of Urology and Renal Transplantation, Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre-Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - B S Santhosh
- Department of Urology and Renal Transplantation, Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre-Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - S J Rizvi
- Department of Urology and Renal Transplantation, Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre-Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Affiliation(s)
- S Sharma
- Department of Urology, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India
| | - S J Rizvi
- Department of Urology, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India
| | - P R Modi
- Department of Urology, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Modi PR, Rizvi SJ, Shah VR, Modi MP, Kanodia KV, Trivedi HL. Outcome of live and deceased donor renal transplantation in patients aged ≥55 years: A single-center experience. Indian J Nephrol 2014; 24:9-14. [PMID: 24574624 PMCID: PMC3927204 DOI: 10.4103/0971-4065.125049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Renal transplantation (RTx) has now become an accepted therapeutic modality of choice for elderly ESRD patients. This single-center study was undertaken to evaluate the outcome of RTx in ESRD patients ≥55 years. A total of 103 patients underwent RTx 79 living related living donors [LD], 24 deceased donors [DD]) at our center. Post-transplant immunosuppression consisted of calcineurin inhibitor-based regimen. The mean donor age was 58.3 years in the LD group and 59.5 years in the DD group. Male recipients constituted 92% in LD and 75% in DD group. In living donor renal transplantation, 1- and 5-year patient survival was 93% and 83.3% respectively and death-censored graft survival was 97.3% and 92.5% respectively. There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections. In deceased donor renal transplantation, 1- and 5-year patient survival was 79.1% and 74.5% respectively and death-censored graft survival was 95.8% and 85.1% respectively. There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections. RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M R Gumber
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H V Patel
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Modi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - S J Rizvi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V R Shah
- Department of Anesthesia and Critical Care, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M P Modi
- Department of Anesthesia and Critical Care, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - K V Kanodia
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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7
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Mehta TR, Shah VR, Butala BP, Parikh GP, Parikh BK, Vora KS, Modi MP, Bhosale GP, Kadam PG, Shah PR, Gumber MR, Patel HV, Kute VB, Modi PR, Rizvi SJ, Vanikar AV, Trivedi HL. Intercity deceased donor renal transplantation: a single-center experience from a developing country. Saudi J Kidney Dis Transpl 2014; 24:1280-4. [PMID: 24231504 DOI: 10.4103/1319-2442.121283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In a developing country such as India, deceased donor renal transplantation (DDRTx) accounts for only about 1% of all renal transplants (RTx). Our institute initiated an intercity DDRTx in the year 2006, which significantly increased the number of RTx. We retrieved 74 kidneys from 37 deceased donors from various cities of Gujarat from January 2006 to December 2009. We transplanted the allografts in 66 recipients and a retrospective analysis of the donor profile and management and recipient outcome was performed. The mean age of the donors was 43.3 ± 18.8 years. The causes of death included road traffic accident in 51.35% of the donors and cerebrovascular stroke in 48.65% of the donors; 83.78% of the donors required ionotropes for hemodynamic stability in addition to vigorous intravenous fluid replacement. The average urine output of the donors was 350 ± 150 mL. The organs were perfused and stored in HTK solution. The mean cold ischemia time (CIT) was 9.12 ± 5.25 h. The mean anastomosis time in the recipient was 30.8 ± 8.7 min. 57.6% of the recipients established urine output on the operating table and 42.4% developed delayed graft function. At the end of 1 month after transplantation, the mean serum creatinine was comparable to the Ahmadabad city DDRTx, although the CIT was significantly longer in the intercity patients. Intercity organ harvesting is a viable option to increase the donor pool. Distance may not be an impediment, and good recipient outcome is possible in spite of prolonged CIT in case of proper harvesting and preservation.
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Affiliation(s)
- T R Mehta
- Department of Anesthesia and Critical Care, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Center (IKDRC) - Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS) Civil Hospital Campus, Asarwa, Ahmadabad, Gujarat, India
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8
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Engineer DP, Modi PR, Rizvi SJ, Shah VR, Modi MP, Kanodia KV, Trivedi HL. Ten kidney paired donation transplantation on World Kidney Day 2013: raising awareness and time to take action to increase donor pool. Ren Fail 2013; 35:1269-72. [PMID: 23937166 DOI: 10.3109/0886022x.2013.823997] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Kidney paired donation (KPD) is feasible for any center that performs living related donor renal transplantation (LRDRTx). Lack of awareness, counseling and participation are important hurdles in KPD patients with incompatible donors. MATERIALS AND METHODS This is an institutional review board approved study of 10 ESRD patients who consented to participate in the KPD transplantation at our center. All the surgeries were carried out on the same day at the same center on the occasion of World Kidney Day (WKD) (14 March 2013). All recipients had anatomic, functional and immunological similar donors. RESULTS KPD were performed to avoid blood group incompatibility (n = 8) or to avoid a positive crossmatch (n = 2). None of the patients experienced delayed graft function and surgical complications. At 3 month follow-up, median serum creatinine was 1 (range 0.6 to 1.25) mg/dL and two patients developed allograft biopsy-proven acute rejection and responded to antirejection therapy. Due to impact of our awareness activity, 20 more KPD patients are medically fit for transplantation and waiting for permission from the authorization committee before transplantation. CONCLUSION This is a report of 10 simultaneous KPD transplantations in a single day in a single centre on WKD raising awareness of KPD. KPD is viable, legal and rapidly growing modality for facilitating LRDRTx for patients who are incompatible with their healthy, willing LRD.
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Affiliation(s)
- Vivek B Kute
- Department of Nephrology and Clinical Transplantation
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9
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Abstract
Vascular anomalies increase the difficulty during live donor nephrectomy. We herein report a left-sided retroperitoneoscopic living donor nephrectomy performed in a donor with a duplicated inferior vena cava (IVC). Computed tomography angiography provided accurate delineation of the venous anatomy and allowed preoperative planning. The duplicated IVC was clipped and divided just below its confluence with the left renal vein. The length of the left renal vein was sufficient for anastomosis in the recipient, and the recipient's serum creatinine was 1.21% on day 7. The donor made an uneventful recovery. Duplicated IVC is not a contraindication for left retroperitoneoscopic donor nephrectomy.
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Affiliation(s)
- S J Rizvi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Centre, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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10
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Vanikar AV, Suthar KS, Kute VB, Rizvi SJ, Trivedi HL. Incidentally detected lymphatic filariasis in a renal allograft recipient. Int J Organ Transplant Med 2013; 4:123-4. [PMID: 25013664 PMCID: PMC4089319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Post-transplntation lymphocele is a well known complication, and lymphatic filariasis (LF) has occasionally been found to present as post-transplantation lymphocele. However, incidentally detected LF during transplantation surgery has not been reported. We present an incidentally detected LF presenting as enlarged lymph node in the right iliac fossa of a recipient during transplantation of donor kidney. He was subsequently treated after transplantation and had stable graft function without any complications after 8 months of follow-up.
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Affiliation(s)
- A. V. Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, ,Correspondence: Aruna V Vanikar, MD, Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R.Doshi and K.M. Mehta Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Civil hospital campus, Asarwa, Ahmedabad, India. Tel: +91-79-2268-7152/7153, Fax: +91-79-2268-5454, E-mail:
| | - K. S. Suthar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology,
| | - V. B. Kute
- Department of Nephrology and Clinical Transplantation,
| | - S. J. Rizvi
- Department of Urology and Transplantation, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India.
| | - H. L. Trivedi
- Department of Nephrology and Clinical Transplantation,
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Affiliation(s)
- P Modi
- Urology and Transplantation Surgery, Smt G R Doshi and Smt K M Mehta Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Abstract
A 25-year-old female presented with a history of recurrent urinary tract infection and end stage renal failure. Voiding cystourethrography revealed bilateral Grade IV vesicoureteral reflux with left to right crossed ectopia. A computed tomography scan showed fusion of both kidneys with the left kidney situated at the lower and anterior part of the right orthotopic moiety. A retroperitoneoscopic nephrectomy with a right side ureterectomy was carried out.
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Affiliation(s)
- Pranjal Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Modi P, Rizvi SJ, Pal B, Baradwaj R, Gupta S, Shah V, Modi M, Shah P, Trivedi H. Living donor paired-kidney exchange transplantation: A single institution experience. Indian J Urol 2011; 26:511-4. [PMID: 21369382 PMCID: PMC3034058 DOI: 10.4103/0970-1591.74446] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introduction: Paired-kidney exchange (PKE) is used in western countries to increase donor pool. In India, there are not many centers involved in PKE program. We present 10 years of this experience and outcome of the recipients. Materials and Methods: Between year 2000 and 2009, 34 transplants with PKE were performed. All donors were live related, and permission from Authorization committee(s) from one or more states was obtained prior to transplantation. Both donor and recipient surgeries were carried out simultaneously in all cases at a single institution. Last 10 donors were offered laparoscopic donor nephrectomy and all other previous donors were operated by open surgery. Results: Five donor–recipient pairs were from the state of Rajasthan, one from Madhya Pradesh, and all others from Gujarat. ABO incompatibility between donor and recipient was present in 12 pairs and positive lymphocyte cross-match in 5 pairs. Conclusion: Paired-kidney-exchange transplantation expands donor pool and total number of transplantation.
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Affiliation(s)
- Pranjal Modi
- Departments of Urology and Transplantation Surgery, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, India
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Abstract
Kidney transplantation from deceased donors is in its infancy in India. Marginal donors are now accepted by many centers for kidney transplantation. We report a case of procurement of en bloc kidneys from a pediatric deceased donor having grade 1 renal injury and transplanted to an adult recipient with a follow up of two years and five months.
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Affiliation(s)
- P Modi
- Department of Urology and Transplantation Surgery, Dr. H. L. Trivedi Institute of Transplantation Sciences, India
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Abstract
Aim: To evaluate safety and efficacy of 5-mm Hem-o-lok clips in children undergoing retroperitoneoscopic nephrectomy. Material and Methods: Twenty-four retroperitoneoscopic nephrectomies were performed between September 2004 and August 2007. The indications of nephrectomy were ureteropelvic junction obstruction, reflux nephropathy, ectopic ureteral opening with renal dysplasia, and stone disease with pyonephrosis and primary obstructed megaureter with renal dysplasia. Nine cases were on right side and others on left side. Multiple 5- or 10-mm Hem-o-lok clips were used to control renal artery and vein separately in each case. The specimen was mobilized and removed either by extension of a port site incision or by a separate incision at ipsilateral iliac fossa at the lateral border of the rectus muscle. Results: Hem-o-lok clips were deployed on renal pedicle separately in each case. Two clips were deployed on the body side and one on the specimen side. On the left side lumbar, gonadal and adrenal tributaries were also clipped by 5-mm Hem-o-lok clips. No clip dislodgement was observed in any patient. Mean operative time was 111 (80 ± 47) minutes, and mean blood loss was 25 (10 ± 45) mL. Mean hospital stay was 2.4 (1.9-3.1) days. Conclusion: Five- and 10-mm Hem-o-lok clips are safe and effective for renal pedicle control during retroperitoneoscopic nephrectomy in children.
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Affiliation(s)
- Pranjal Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Ahmedabad, India
| | - S J Rizvi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Ahmedabad, India
| | - Rahul Gupta
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Ahmedabad, India
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16
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Affiliation(s)
- Pranjal Modi
- Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Department of Urology and Transplantation Surgery; Ahmedabad, India.
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Abstract
PURPOSE We assessed the results of laparoscopic ureteroneocystostomy with a psoas hitch for iatrogenic lower ureteral injuries leading to a ureterovaginal fistula. MATERIALS AND METHODS Between July 2003 and November 2007, 18 patients with iatrogenic lower ureteral injuries during hysterectomy leading to ureterovaginal fistula underwent laparoscopic ureteroneocystostomy with a psoas hitch. Of the patients 17 underwent abdominal or vaginal hysterectomy, while in 1 with a ruptured gravid uterus emergency hysterectomy was done for uncontrolled bleeding. Mean patient age was 35.5 years (range 23 to 45) and mean time to surgery since the injury was 2.2 months (range 1.5 to 3.5). Transperitoneal 3 or 4 port laparoscopic ureteroneocystostomy with a psoas hitch was performed. RESULTS Of the procedures 17 were completed successfully. Intraoperative cardiac arrhythmia occurred in 1 patient due to pneumoperitoneum and hypercarbia, requiring open conversion. Mean operative time was 2.5 hours (range 1.9 to 2.8) hours, mean blood loss was 90 ml (range 45 to 150) and total hospital stay was 5.3 days (range 2.9 to 8). The nephrostomy tube was blocked on the table in all patients and it was removed on day 7. At an average followup of 26.4 months (range 3 to 52) postoperative excretory urography did not reveal obstruction in any patient. One patient had vesicoureteral reflux on voiding cystogram. CONCLUSIONS Laparoscopic ureteroneocystostomy with a psoas hitch for ureterovaginal fistula secondary to hysterectomy is safe and effective, and associated with a low incidence of postoperative reflux and obstruction.
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Affiliation(s)
- Pranjal Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre, Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Modi P, Goel R, Rizvi SJ. Case report: laparoscopic pyeloplasty for ureteropelvic junction obstruction of lower moiety in duplex system. J Endourol 2008; 21:1037-40. [PMID: 17941783 DOI: 10.1089/end.2006.0333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Ureteropelvic junction (UPJ) obstruction can be associated with renal anomalies. We report a case of laparoscopic dismembered pyeloplasty in a lower moiety of a complete duplex system. CASE REPORT A 40-year-old woman presented with right flank pain. Intravenous urography revealed a typical UPJ obstruction on the right side, and a diuretic renal scan showed 35% uptake of the tracer and a glomerular filtration rate of 57 mL/min with delayed excretion (T1/2 28 minutes). Transperitoneal laparoscopic dismembered pyeloplasty was performed. The operative time was 140 minutes with a blood loss of 30 mL. Diclofenac sodium (total requirement 150 mg) was used for analgesia. A diuretic renal scan at 3 months showed 41% uptake and a glomerular filtration rate of 66 mL/min, with prompt drainage without obstruction of the right kidney (T(1/2) 18 minutes). At 6 months' follow-up, the patient was symptom free. CONCLUSION To our knowledge, our report is the third where laparoscopic pyeloplasty for a duplex system was carried out. Prior placement of Double-J stent made identification of the ureter draining the lower moiety during laparoscopic surgery much easier. The principles of open surgery could be duplicated.
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Affiliation(s)
- Pranjal Modi
- Department of Urology, Institute of Kidney Diseases and Research Centre, Ahmedabad, India.
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Feroz A, Dabhi M, Gumber M, Gupta S, Shah PR, Rizvi SJ, Modi PR, Shah SA, Khemchandani S, Bhandari NS, Bhosale GP, Shah VR, Trivedi VB, Dave AP, Dave JM, Trivedi HL. Cadaveric Renal Transplantation: Our Experience at the Institute of Kidney Diseases & Research Centre, Institute of Transplantation Sciences, Ahmedabad. Transplant Proc 2007; 39:721-2. [PMID: 17445581 DOI: 10.1016/j.transproceed.2007.01.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a developing country such as India, cadaveric renal transplantation accounts for only less than 1% of total renal transplantations. The reasons for such a low rate of cadaveric transplantation are many, ranging from lack of awareness to socioeconomic reasons. Our institute conducted a statewide public awareness program and initiated an intercity organ harvesting program. This doubled the cadaveric renal transplantations in the last 2 years. We performed 38 cadaveric transplantations among 190 renal transplantations in the last year (August 2005 to July 2006). We retrieved kidneys from 21 donors, of whom 9 were outside our city. From 21 donors we transplanted 38 recipients; out of whom 3 received dual kidneys and one kidney was discarded. The Mean age of the donors was 41.4 +/- 18.2 years with a mean cold ischemia time of 6.9 +/- 3.8 hours. Sixty-eight percent had delayed graft function. At the last follow-up, which was 190 +/- 98 days, patient survival rate was 90%: 4 patients died, including 2 due to bacterial sepsis and 2 due to cytomegalovirus (CMV) disease. The Graft survival rate was 85%, and the death-censored graft survival rate was 90%. Mean serum creatinine value at the last follow-up was 1.2 +/- 0.3 mg%. There were 5 episodes of acute rejection in 31 patients during first 3 months (16% acute rejection rate). The increase in cadaveric transplantations was associated with satisfactory patient and graft survival despite the high incidence of delayed graft function.
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Affiliation(s)
- A Feroz
- Department of Nephrology and Transplantation Medicine, Dr H L Trivedi Institute Of Transplantation Sciences, Ahmedabad, Gujarat, India.
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Abstract
All over the world epileptic patients have traditionally been discriminated legally in matters affecting their everyday existence. India is no exception. In the current paper certain important issues are explored, namely, epilepsy in relation to marriage, criminality, driving and socio-economic crimes.
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Affiliation(s)
- M Husain
- Department of Forensic Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh
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21
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Hussain M, Rizvi SJ, Usmani JA. Dowry cannibalism. J Clin Forensic Med 1996; 3:179-81. [PMID: 15335605 DOI: 10.1016/s1353-1131(96)90024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The term dowry cannibalism is used in this article to describe a unique case where the motive for cannibalism was the non-fulfilment of a husband's dowry demands from his wife. The husband was accused by the wife of regularly using a syringe to withdraw blood from her, with the intent of causing her death, and drinking it. Intriguing as this is, it is also medicolegally important: this method of killing might leave no trace suggesting murder. It is postulated that this form of abuse may also significantly alter the psychological state of the victim and hasten death. The case is not yet concluded, and may never be, thus details to allow identification have been omitted from the report.
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Affiliation(s)
- M Hussain
- Department of Forensic Medicine, J. N. Medical College, Aligarh Muslim University, Aligarh 202 002, India
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Zafar MN, Rizvi SJ, Syed S. Thyroid hormone levels in hepatitis B. J PAK MED ASSOC 1992; 42:56-7. [PMID: 1629997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Thyroid hormone levels were estimated in fifty patients with hepatitis B. In acute phase, T3 was raised in 10% and T4 in 60%. This rise was directly proportional to the transaminases levels. Twenty cases were also studied in the recovery phase where thyroid hormones returned to within normal limits. This rise of T3 and T4 in acute phase is attributed to increased thyroxin binding capacity due to release of thyroid binding globulin into circulation from necrosing hepatocytes.
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Usmani JA, Rizvi SJ. Postmortem changes of blood urea, creatinine, non-protein nitrogen, uric acid & ammonia levels in rabbit. Indian J Med Res 1988; 88:545-9. [PMID: 3243616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Haque N, Rizvi SJ, Khan MB. Malathion induced alterations in the lipid profile and the rate of lipid peroxidation in rat brain and spinal cord. Pharmacol Toxicol 1987; 61:12-5. [PMID: 3628175 DOI: 10.1111/j.1600-0773.1987.tb01764.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Malathion, known as a low toxic pesticide, is frequently used in the third world. Neurotoxic manifestations of malathion were evaluated on various lipids and lipid peroxidation in different brain areas following intraperitoneal injections (150 mg/kg body weight for 7 consecutive days) to albino rats. Clinical investigations show that malathion produced hypomotor activity and hyperthermia. Lipid components were differently affected by this pesticide, where total lipids and phospholipids were diminished in the spinal cord and brain stem, respectively. Increased contents of cholesterol were found in the cerebellum and spinal cord. Also, total lipids were increased in the cerebellum. The cholesterol/phospholipids ratio was increased in the cerebellum, brain stem and spinal cord. Rate of lipid peroxidation was found to be increased in all parts of the brain following malathion intoxication.
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Rizvi SJ, Jaiswal V, Mukerji D, Mathur SN. Antifungal properties of 1,3,7-trimethylxanthine, isolated from Coffea arabica. Naturwissenschaften 1980; 67:459-60. [PMID: 7422010 DOI: 10.1007/bf00405645] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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