Publications by authors named "Karthikeyan V S"

Melanoma is a highly aggressive malignancy originating from melanocytes, characterized by its potential to arise in various anatomic locations, both common and rare. The incidence of melanoma has been steadily increasing globally, with variations in clinical presentation, tumor behavior, and prognosis depending on the anatomical site involved. Understanding the diverse pathological spectrum of melanoma is critical for optimizing diagnostic and therapeutic strategies.

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Purpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels.

Materials And Methods: The study was performed in compliance with the Meta-Analysis and Systematic Reviews of Observational Studies (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study design) model.

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  • Non-obstructive azoospermia (NOA) is a prevalent and complex issue with varied treatment options and no definitive guidelines, leading to differing management practices internationally.
  • A comprehensive survey with 336 responses from specialists in 49 countries explored current medical and surgical strategies for NOA, analyzing results against existing guidelines and offering expert recommendations.
  • Key findings included diverse approaches to hormonal therapy, significant variation in sperm retrieval success rates, and differing protocols around varicocele repair and follicle-stimulating hormone cutoff levels for sperm retrieval.
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  • * Conducted from July to September 2022, a questionnaire gathered responses from 367 doctors in 49 countries, focusing on how they diagnose NOA through methods like hormone tests and genetic analyses.
  • * The survey identified that while many practices align with guidelines, significant differences in approaches were found, underscoring the need for standardized, evidence-based international guidelines for NOA evaluation.
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  • The study investigates global practices and challenges in using sperm DNA fragmentation (SDF) assays, which can affect male reproductive potential, as outlined in the latest WHO manual.
  • A survey of 436 reproductive clinicians revealed that the most popular SDF assay is TUNEL, with a significant influence from availability on their choices.
  • Clinicians see the value of SDF testing in understanding infertility but face barriers like insufficient professional guidelines and a lack of accepted reference values for interpreting SDF results.
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  • The meta-analysis investigates the effects of varicocele repair on semen parameters in infertile males, combining data from diverse studies without language restrictions.
  • A total of 351 studies were analyzed, revealing significant improvements in several semen parameters post-repair, including semen volume, sperm concentration, total sperm count, motility, and morphology, while sperm vitality showed no improvement.
  • This research is the largest of its kind and highlights the benefits of varicocele repair for male infertility, contributing valuable insights for clinical practice.
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  • AI has rapidly advanced in medicine, particularly benefiting fields like andrology and reproductive medicine through technologies like machine learning and neural networks.
  • AI tools can enhance the diagnosis and treatment of male infertility, improve patient care accuracy, and increase efficiency in clinical management and research.
  • Future advancements in AI integration are expected to lead to significant breakthroughs and improvements in evidence-based practices within andrology and reproductive medicine.
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  • The study investigates global practices for managing sperm DNA fragmentation (SDF) in infertile men, highlighting its impact on fertility and assisted reproductive technology (ART).
  • A survey collecting data from 436 reproductive experts across 55 countries revealed a common recommendation for lifestyle changes and antioxidants, with varying durations for treatment and differing management approaches for specific infertility cases.
  • The findings indicate a lack of uniformity in practices, emphasizing the need for standardized guidelines and expert consensus for treating men with elevated SDF.
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  • The study explores global practices for sperm DNA fragmentation (SDF) testing in infertile men, following its inclusion in the WHO laboratory manual.
  • A survey conducted among 436 infertility clinicians across 55 countries reveals varied testing practices, with many testing SDF in cases of unexplained infertility, recurrent pregnancy loss, and among smokers.
  • The findings highlight the need for clearer professional guidelines on SDF testing, given the diversity in current practices and the potential benefits for certain patient populations.
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  • Infertility is a global issue affecting about 186 million people, with male factors contributing to around half of all cases, indicating a growing prevalence of male infertility over the past 40 years.
  • The field of Andrology, which focuses on male reproductive health, has faced challenges due to cultural neglect regarding male partners in infertility diagnosis and treatment, and reliance on assisted reproductive techniques (ART) may overlook the importance of male gamete quality.
  • Recent advancements in Andrology, including research on genetics, oxidative stress, and innovative technologies like artificial intelligence and gene engineering, highlight a critical need for further studies to better understand male infertility and improve ART outcomes.
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Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes.

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Introduction: The word "simple" means "easily done" or "presenting no difficulty." Hence, the "Simple Nephrectomy" (SN) operation should be "easy to perform." However, in clinical practice, we have noticed that SN can be equally or more challenging surgery than radical nephrectomy (RN).

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Renal tuberculosis presenting as renal cyst is rare. Diagnosing renal tuberculosis in pregnancy is usually delayed due to its atypical presentation. We present a 28-year-old postpartum lady who delivered a healthy baby one month back, with history of intermittent fever and chills.

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Ureteral strictures are usually caused by ureteral calculi, endoscopic instrumentation, infections like tuberculosis, surgical dissection, radiation, malignancy and periureteral fibrosis. A 42-year-old man presented with right loin pain 2 months previously. Contrast-enhanced computed tomography showed right lower ureteral stricture and he was scheduled for right ureteral reimplantation.

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Unlabelled: Emphysematous pyelonephritis (EPN) is characterized by fulminant necrotizing infection of the kidney and perirenal tissues. Emphysematous pyelonephritis presenting as pneumomediastinum is quite rare. A 65-year-old gentleman presented to us with respiratory failure on ventilator support and uncontrolled sugars.

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Hematuria following percutaneous nephrolithotomy (PCNL) is a dreaded complication. It necessitates blood transfusion in up to 10% of patients. It may be severe enough in <1% of patients to require angioembolization.

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Retrograde pyelography (RGP) is done to evaluate the collecting system when intravenous contrast studies are contraindicated due to renal insufficiency or prior adverse reactions. We report a patient who developed acute renal shutdown following bilateral RGP in the same sitting done for evaluation of positive malignant cytology of urine. A 65-year-old man on treatment for left stroke and hypertension, with a baseline serum creatinine of 1.

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Article Synopsis
  • - The study investigates the effectiveness of adding "sterile pyuria" (SP) as a minor criterion in the Composite Reference Standard (CRS) for diagnosing urinary tract tuberculosis (UTB).
  • - Data was collected from patients diagnosed with UTB between January 2009 and February 2016, showing that SP was present in 65.7% of patients examined.
  • - Incorporating SP as a minor criterion could increase diagnostic accuracy by 8%, significantly reducing the need for histopathology by 70%.
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The common causes of irritative voiding symptoms in women include cystitis, vesical calculi, carcinoma bladder and neurologic disorders. Isolated primary vesical amyloidosis (VA) is a rare cause of irritative voiding symptoms. A 50-year-old female, a known case of retroviral disease but not on anti-retroviral therapy, presented with right flank and suprapubic pain for six months, worsening over the past 15 days with dysuria.

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Objective: Percutaneous nephrolithotomy (PCNL) carries significant potential for morbidity. Scant data exists on indications and outcomes of second-look PCNL after a failure to completely clear renal stones at the first attempt. We present our experience with second-look PCNL.

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Introduction: Children with posterior urethral valve (PUV) may develop urinary bladder (UB) dysfunction even after valve fulguration (VF). Using Urodynamics (UDS), we sought to identify whether age at VF and time elapsed since VF contributed to UB dysfunction.

Materials And Methods: Between January 2009 and July 2016, 39 PUV patients referred to a tertiary care center for UDS were classified into Groups A and B (based on age if <2 or ≥2 years at VF) and subclassified into Group A1/A2 and B1/B2 depending on time duration after VF (TVU).

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Introduction: Emphysematous pyelonephritis (EPN) is a rare clinical entity, characterized by gas in the renal system, due to an acute, fulminant and potentially fatal necrotizing process with varying clinical presentations. It is much more aggressive than uncomplicated pyelonephritis, with the mortality of 20-40% in the contemporary meta-analysis.

Material And Methods: A retrospective record review of inpatients at the Institute of Nephro Urology, Bangalore, India (2007-2014), who were treated after EPN was diagnosed with the aid of a CT (computed tomography) scan.

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Introduction: Tubeless pediatric percutaneous nephrolithotomy (TL-PCNL) is evolving and adult criteria are being safely applied to children. We examine the feasibility, safety, and outcomes of pediatric TL.

Materials And Methods: A retrospective review of pediatric (≤18 years) PCNL patients at our institute was done.

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A 34-year-old hypertensive woman with a hyperdynamic, left brachiobasilic dialysis fistula presented with a long history of throbbing in her head and swelling of the left side of the face. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalized after dilatation and stenting with resolution of all the symptoms and patient is asymptomatic for 1 year.

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Purpose: Urosepsis implies clinically evident severe infection of urinary tract with features of systemic inflammatory response syndrome (SIRS). We validate the role of a single Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 hours after admission in predicting mortality in urosepsis.

Materials And Methods: A prospective observational study was done in 178 patients admitted with urosepsis in the Department of Urology, in a tertiary care institute from January 2015 to August 2016.

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