Publications by authors named "Sanjay Goyal"

6 Publications

  • Page 1 of 1

Efficacy and safety of avanafil as compared with sildenafil in the treatment of erectile dysfunction: A randomized, double blind, multicenter clinical trial.

Int J Urol 2022 04 26;29(4):351-359. Epub 2022 Jan 26.

Department of Clinical Research and Regulatory Affairs, Zydus Healthcare Limited, India.

Objective: To compare the efficacy and safety of avanafil as compared with sildenafil in the management of patients with erectile dysfunction.

Methods: It was a prospective, randomized, double-blind, two-arm, active-controlled, parallel, multicenter, non-inferiority clinical study carried out in patients with erectile dysfunction for at least 3 months and International Index of Erectile Function - Erectile Function domain score of <26 at enrolment.

Results: A total of 220 patients were randomized to receive either avanafil tablets 100 mg or sildenafil tablets 50 mg in 1:1 ratio. After 4 weeks of treatment, 40.0% of patients in the avanafil group and 45.6% of patients in the sildenafil group required dose escalation to a high dose (avanafil 200 mg/sildenafil 100 mg). The difference in the mean change of International Index of Erectile Function - Erectile Function score from baseline in the two groups increased from week 4 (1.1, 95% confidence interval -0.2 to 2.5) to week 8 (1.4, 95% confidence interval 0.1-2.7) and week 12 (2.1, 95% confidence interval 0.8-3.5), showing non-inferiority at week 4, and superiority at week 8 and week 12. Avanafil showed a faster onset of action as shown by a significantly better response to modified Sexual Encounter Profile 1 in the avanafil group (84.8%) as compared with that in the sildenafil group (28.2%; P < 0.001). Both avanafil and sildenafil were well tolerated by all the patients in the study; the most common adverse event reported during the study was headache in both the groups.

Conclusion: Avanafil is superior to sildenafil in improving the International Index of Erectile Function - Erectile Function domain score at the end of 12 weeks of treatment with the added advantage of faster onset of action.
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http://dx.doi.org/10.1111/iju.14785DOI Listing
April 2022

Biomarkers of Major Depressive Disorder: Knowing is Half the Battle.

Clin Psychopharmacol Neurosci 2021 Feb;19(1):12-25

Department of Internal Medicine, Government Medical College, Patiala, India.

Major depressive disorder (MDD) is a heterogeneous disease which is why there are currently no specific methods to accurately test the severity, endophenotype or therapy response. This lack of progress is partly attributed to the com-plexity and variability of depression, in association with analytical variability of clinical literature and the wide number of theoretically complex biomarkers. The literature accessible, indicates that markers involved in inflammatory, neuro-trophic and metabolic processes and components of neurotransmitters and neuroendocrine systems are rather strong indicators to be considered clinically and can be measured through genetic and epigenetic, transcriptomic and proteomic, metabolomics and neuroimaging assessments. Promising biologic systems/markers found were i.e., growth biomarkers, endocrine markers, oxidant stress markers, proteomic and chronic inflammatory markers, are discussed in this review. Several lines of evidence suggest that a portion of MDD is a dopamine agonist-responsive subtype. This review analyzes concise reports on the pathophysiological biomarkers of MDD and therapeutic reactions via peripheral developmental factors, inflammative cytokines, endocrine factors and metabolic markers. Various literatures also support that endocrine and metabolism changes are associated with MDD. Accumulating evidence suggests that at least a portion of MDD patients show characteristics pathological changes regarding different clinical pathological biomarkers. By this review we sum up all the different biomarkers playing an important role in the detection or treatment of the different patients suffering from MDD. The review also gives an overview of different biomarker's playing a potential role in modulating effect of MDD.
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http://dx.doi.org/10.9758/cpn.2021.19.1.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851463PMC
February 2021

Duodenal Web with Trichobezoar: An Unusual Presentation.

Indian Pediatr 2020 08;57(8):757

Department of Radiodiagnosis, Jaipur Golden Hospital, New Delhi, India.

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August 2020

Acute Bilateral Cataract in Patient with Type 1 Diabetes Mellitus.

J Assoc Physicians India 2019 Apr;67(4):83

Junior Resident, Department of Medicine, Rajindra Hospital, Patiala, Punjab.

Introduction: Cataract represents one of the most frequent eye complications in type 1 DM and type 2 DM patients; contrarily, acute cataract in young diabetic patients occurs very rarely. Only few cases with acute bilateral cataract - all relatively shortly after the diagnosis of type 1 DM have been reported. It can affect visual acuity from slight visual impairment to complete blindness. Although usually associated with chronic hyperglycaemia, it may also occur on rapid restoration of euglycaemia.1 Early detection of diabetes and adequate glycaemic control, particularly in female adolescents, may prevent this debilitating complication of diabetes.
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April 2019

Stepwise case selection using Guy's stone score reduces complications during percutaneous nephrolithotomy training.

Indian J Urol 2017 Jan-Mar;33(1):41-47

Department of Urology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Andhra Pradesh, India.

Introduction: Traditional percutaneous nephrolithotomy (PCNL) training involved subjective award of cases to the trainee. We restructured this according to the Guy's stone score (GSS) such that each trainee stepwise completed 25 cases of each grade before progressing. This study compares the outcomes of training with traditional versus stepwise approach.

Methods: Four hundred consecutive cases equally distributed for two trainees in each group were compared in terms of complications (Clavien-Dindo), stone free rate (SFR), operative and fluoroscopy time. External comparison was also done against a benchmark surgeon. Multivariable regression model was created to compare SFR and complications while adjusting for comorbidity, Amplatz size, access tract location, number of punctures, body mass index, stone complexity, and training approach.

Results: The distribution of cases in terms of calculus complexity was similar. Overall, in comparison to traditional training, stepwise training had significantly shorter median operative time (100 vs. 120 min, < 0.05), fluoroscopy time (136 vs. 150 min, < 0.05) and fewer overall (29.5% vs. 43.5%, < 0.005) as well as major complications (3% vs. 8.5%, - 0.029), though initial SFR was higher but not statistically significant (77% vs. 71.5%). On multivariable analyses, stepwise training was independently associated with lower complications (odds ratio 0.46 [0.20-0.74], - 0.0013) along with GSS grade, number of punctures, and Amplatz size. Stepwise training had similar fluoroscopy time, major complications and final clearance rate compared to expert surgeon.

Conclusions: PCNL has a learning curve specific for each grade of calculus complexity and stepwise training protocol improves outcomes.
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http://dx.doi.org/10.4103/0970-1591.195757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264192PMC
February 2017

Giant renal angiomyolipoma.

BMJ Case Rep 2009 14;2009. Epub 2009 Dec 14.

C.M.I. Hospital Dehradun, Surgery, 54 Haridwar Road, Dehradun, 248001, India.

A 65-year-old woman from a rural area presented to the surgical service with a very large abdominal lump that the patient had first noticed 8 years previously. The lump had steadily increased in size over time, and the patient had dysuria, weakness and dyspnoea on exertion. On examination she was grossly anaemic with a large retroperitoneal lump that occupied the whole right side of abdomen; the lump was soft to firm in consistency and non-tender. She had no lymphoedema or other palpable lymph nodes. Ultrasound revealed a large retroperitoneal tumour with fatty elements, arising from the right kidney. There was no involvement of the intestines. Findings of the computed tomography scan were typical for renal angiomyolipoma. The patient underwent surgery and the tumour was excised. Four units of blood were transfused preoperatively and in addition two units were given postoperatively. The patient was given thromboprophylaxis perioperatively and in the postoperative period because she was bedridden and could not ambulate. She made an uneventful recovery.
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http://dx.doi.org/10.1136/bcr.04.2009.1747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3027913PMC
October 2012
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