Publications by authors named "Suresh Goyal"

9 Publications

  • Page 1 of 1

Epidemiology and Genotype Distribution of Rotavirus Gastroenteritis in Under-Five Children of South Rajasthan, India.

Indian J Pediatr 2021 Mar 2;88(Suppl 1):105-111. Epub 2021 Feb 2.

The Wellcome Trust Research Laboratory, Christian Medical College (CMC), Vellore, Tamil Nadu, India.

Objective: To determine the epidemiology of rotavirus diarrhea and its genotypes distribution among under five children from Udaipur, Rajasthan.

Methods: Hospital-based prospective study among children aged 0-59 mo of age hospitalized due to acute gastroenteritis and assess the clinical and epidemiological profile. Stool samples collected during 2017-2019 from 734 children, were tested by enzyme immune assay (EIA) to identify rotavirus and the samples that were positive were subjected to genotyping using published methods.

Results: Rotavirus was detected in 12.94% (95/734) of the stool samples. Maximum positivity (38.9%) was seen in children aged 12-23 mo followed by 34.7% in 6-11 mo of age. Detection rates were higher (46.31%, 44/95) during winter months of December-February; 65% children with rotavirus diarrhea had severe dehydration followed by moderate dehydration in 32% of cases. G3P[8] (40, 43.01%) was the commonest genotype followed by G9P[4] (10, 10.75%).

Conclusion: Among under-five children hospitalized due to acute gastroenteritis in a tertiary care setting in Udaipur, Rajasthan, 12.9% of children were rotavirus positive with predominant (43.01%) circulation of G3P[8] strains.
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http://dx.doi.org/10.1007/s12098-020-03626-zDOI Listing
March 2021

Erdafitinib as a Novel and Advanced Treatment Strategy of Metastatic Urothelial Carcinoma.

Anticancer Agents Med Chem 2021 Jan 20. Epub 2021 Jan 20.

Multidisciplinary Research Unit, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri Garhwal. India.

Urothelial carcinoma has become the ninth most common malignancy in the world. Since 1980s, diverse studies and treatment methods came out with their possible effects along with certain limitations. Initially, platinum chemotherapy was considered as first line treatment of the disease. Although it was proved to be effective in the beginning yet most number of cases reported the reoccurrence of the disease. Furthermore, aberrant ligand-dependent and constitutive ligandindependent fibroblast growth factor receptor (FGFR) signalling has been reported in large number of solid tumours including urothelial carcinoma that became the basis for FGFR inhibition for the treatment of the disease. Erdafitinib is a pan-FGFR inhibitor that was recently approved in the USA for the treatment of locally advanced or metastatic FGFR3 or FGFR2 urothelial carcinoma. The drug is also being investigated as a treatment for other cancers including cholangiocarcinoma, liver cancer, non-small cell lung cancer, prostate cancer, lymphoma cancer and oesophageal cancer. This article summarizes the various treatments evolved for bladder cancer till now, brief description of biology of FGFR inhibition, clinical pharmacology and various clinical trials of erdafitinib.
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http://dx.doi.org/10.2174/1871520621666210121093852DOI Listing
January 2021

A Hospital-Based Multi-Centric Study to Determine the Clinico-Epidemiological Profile of Intussusception in Children < 2 Years in Rajasthan, India.

Indian J Pediatr 2021 Mar 6;88(Suppl 1):131-137. Epub 2021 Jan 6.

Christian Medical College, Vellore, Tamil Nadu, India.

Objective: To determine the clinical and epidemiological profile of Intussusception in children aged <2 y after introduction of rotavirus vaccine in Universal Immunization Programme of Rajasthan.

Method: This was a hospital-based multi-centric surveillance study conducted at three tertiary care sentinel sites in Rajasthan over a period of 2 y. Children <2 y of age admitted with intussusception as per Brighton's criteria 1 were enrolled. Demographic details including age, sex, clinical presentation, diagnostic methods, duration of symptoms, mode of treatment, and complications were recorded and analyzed.

Results: During the study period of 2 y, the authors identified 164 cases of intussusception based on level-1 Brighton's criteria. Median age at presentation was 7 mo [Interquartile range (IQR) 5-10 mo] with a male to female ratio of 2:1. Pain abdomen and blood stained stool were the commonest presenting complaints (88.4% and 81.7%, respectively). Commonest site of intussusception was Ileocolic (82.32%). Pathological lead point was identified in 18.9% cases. Distinct seasonality was observed as maximum cases of intussusception were detected in the months of Jan-March (34.1%). Surgical intervention was required in the 89.63% cases. The median time duration between onset of symptoms and admission at sentinel site was 2 d (IQR 1-3 d). Proportion of cases that required surgery increased as the time interval between onset of symptoms and admission increases.

Conclusion: Intussusception is a common surgical condition among children under-two years of age with majority of cases occurring during infancy. Case management is dependent primarily on time duration elapsed between symptoms onset and admission to tertiary care centre. Early case detection and timely referral may provide an opportunity to avoid surgical interventions.
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http://dx.doi.org/10.1007/s12098-020-03601-8DOI Listing
March 2021

Intussusception after Rotavirus Vaccine Introduction in India.

N Engl J Med 2020 11;383(20):1932-1940

From the Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences (S.N.R., N.P.N., V.T., S. Giri, I.P., S. Babji, S. Bidari, S. Senthamizh, G.K.), and the Department of Community Health (V.R.M.), Christian Medical College Vellore (T.J.K.J.), and Government Vellore Medical College (G.V.), Vellore, Kanchi Kamakoti Child Trust Hospital (B.S.), the National Institute of Epidemiology (G.K.C.P.), and the Institute of Child Health (P.D., M.J.), Chennai, Government Rajaji Hospital and Madurai Medical College, Madurai (K.M., H.B.), Coimbatore Medical College, Coimbatore (R.M., R. Gurusamy), the Indian Council of Medical Research, New Delhi (S. Giri, I.P., M.D.G.), Translational Health Science and Technology Institute, Faridabad (R.A., G.K.), Kurnool Medical College and Government General Hospital, Kurnool (S.M.), Government General Hospital and Rangaraya Medical College, Kakinada (K.B.G., B.R.), King George Hospital and Andhra Medical College, Visakhapatnam (P.P., R.P.G.), Sri Venkateshwara Medical College, Tirupati (M.B., V.M.), Sardar Valla Bhai Patel Post Graduate Institute of Paediatrics, Cuttack (S. Sathpathy, H.M.), the Institute of Medical Sciences and SUM Hospital, Bhubaneswar (M.D.), Kalinga Institute of Medical Sciences (N.K.M.) and Hi-Tech Hospital (R.K.R., P.M.), Bhubaneswar, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (G.G.), Shaheed Hasan Khan Mewati Government Medical College, Mewat (S.C.), Post Graduate Institute of Medical Education and Research, Chandigarh (M.G.), Sawai Man Singh Medical College, Jaipur (R. Gupta), Rabindranath Tagore Medical College, Udaipur (S. Goyal), Dr. Sampurnanand Medical College, Jodhpur (P.S.), Malankara Orthodox Syrian Church Medical College Hospital, Kolencherry (M.A.M.), Jawaharlal Nehru Institute of Post-graduate Medical Education and Research, Puducherry (S.K., A.S.), Mahatma Gandhi Memorial Medical College, Indore (H.J.), the Government Medical College, Guwahati, Assam (J.K.G.), King George Medical College, Lucknow (A.W.), and the Institute of Medical Sciences, Banaras Hindu University, Varanasi (V.G.) - all in India; and the Centers for Disease Control and Prevention, Atlanta (J.E.T., U.D.P.).

Background: A three-dose, oral rotavirus vaccine (Rotavac) was introduced in the universal immunization program in India in 2016. A prelicensure trial involving 6799 infants was not large enough to detect a small increased risk of intussusception. Postmarketing surveillance data would be useful in assessing whether the risk of intussusception would be similar to the risk seen with different rotavirus vaccines used in other countries.

Methods: We conducted a multicenter, hospital-based, active surveillance study at 27 hospitals in India. Infants meeting the Brighton level 1 criteria of radiologic or surgical confirmation of intussusception were enrolled, and rotavirus vaccination was ascertained by means of vaccination records. The relative incidence (incidence during the risk window vs. all other times) of intussusception among infants 28 to 365 days of age within risk windows of 1 to 7 days, 8 to 21 days, and 1 to 21 days after vaccination was evaluated by means of a self-controlled case-series analysis. For a subgroup of patients, a matched case-control analysis was performed, with matching for age, sex, and location.

Results: From April 2016 through June 2019, a total of 970 infants with intussusception were enrolled, and 589 infants who were 28 to 365 days of age were included in the self-controlled case-series analysis. The relative incidence of intussusception after the first dose was 0.83 (95% confidence interval [CI], 0.00 to 3.00) in the 1-to-7-day risk window and 0.35 (95% CI, 0.00 to 1.09) in the 8-to-21-day risk window. Similar results were observed after the second dose (relative incidence, 0.86 [95% CI, 0.20 to 2.15] and 1.23 [95% CI, 0.60 to 2.10] in the respective risk windows) and after the third dose (relative incidence, 1.65 [95% CI, 0.82 to 2.64] and 1.08 [95% CI, 0.69 to 1.73], respectively). No increase in intussusception risk was found in the case-control analysis.

Conclusions: The rotavirus vaccine produced in India that we evaluated was not associated with intussusception in Indian infants. (Funded by the Bill and Melinda Gates Foundation and others.).
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http://dx.doi.org/10.1056/NEJMoa2002276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492078PMC
November 2020

Evaluation of Quantitative and Qualitative Renal Outcome Following Nephron Sparing Surgery.

J Clin Imaging Sci 2018 16;8:15. Epub 2018 Apr 16.

Department of Urology, All India Institute of Medical Sciences, Jodhpur, India.

Purpose: Preservation of renal function after nephron-sparing surgery (NSS) is multifactorial and the impact of individual factors on it is still a debate. This prospective study investigates the impact of factors responsible for quantitative and functional outcome after NSS.

Patients And Methods: Fifty-two patients of localized renal mass (≤7 cm) were included in the study. A contrast-enhanced computed tomography abdomen was performed for characterization of tumor. Glomerular filtration rate (GFR) was calculated using Tc99m-diethylenetriamine pentaacetic acid (DTPA) scan and Cockcroft-Gault (CG) formula. All relevant intra- and peri-operative events were noted. Follow-up work up performed at 3 months.

Results: Overall, the mean ischemia time was 30.6 min, with 7.7% decrease in renal volume in the operated moiety. In follow-up, the total and ipsilateral GFR decreased. Change in renal parenchymal volume, total GFR by CG and DTPA, split GFR of tumor-bearing moiety was significant in follow-up. Size, stage, polar location of tumor, duration of surgery, type of ischemia, preoperative chronic kidney disease, and need of blood transfusion did not affect change in renal volume and function in the follow-up period.

Conclusion: Renal parenchymal loss and duration of ischemia have impact on the follow-up renal function.
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http://dx.doi.org/10.4103/jcis.JCIS_82_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939037PMC
April 2018

Comparative efficacy of tamsulosin versus tadalafil as medical expulsive therapy for distal ureteric stones.

Urol Ann 2018 Jan-Mar;10(1):82-86

Department of Urology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.

Objective: The objective of this study was to compare the relative efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteric stones.

Patients And Methods: This was a prospective study performed between December 2014 and February 2016. A total of 123 adult patients (>18 years of age) presenting with distal ureteric stones sized 6-10 mm were randomized to treatment with tamsulosin 0.4 mg once daily (Group A) or tadalafil10 mg once daily (Group B). Therapy was given for a maximum of 4 weeks. The stone expulsion rate was the primary endpoint. Time to stone expulsion, number of colic episodes, analgesic use, number of hospital visits for pain, endoscopic treatment, and adverse effects of the drugs were noted. Statistical analyses were done using Fisher's exact test and Chi-square test.

Results: A total of 61 patients were included in tamsulosin group and 62 patients in tadalafil group. A statistically insignificant difference was found for stone clearance rate between both groups as a whole (Group A-73.77%, Group B-69.35%, = 0.690) as well as when we considered both subgroups (A1-78.05%, B1-75.0%, = 0.802; A2-65.0%, B2-55.6%, = 0.741). All the primary and secondary outcome measures were more in favour of stones ≤8 mm size than stones >8 mm size. No statistical difference was found for adverse drug effects except for retrograde ejaculation, which was significantly high in tamsulosin group ( < 0.001).

Conclusion: This study showed that although tamsulosin is more effective for stone clearance than tadalafil, but this difference was not significant ( = 0.690).
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http://dx.doi.org/10.4103/UA.UA_36_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791464PMC
February 2018

The incidence of isolated penile torsion in North India: A study of 5,018 male neonates.

J Pediatr Urol 2017 Oct 1;13(5):491.e1-491.e6. Epub 2017 Mar 1.

Department of Obstetric and Gynecology, S.P. Medical College Bikaner, Rajasthan, India.

Objective: Congenital penile torsion is a three-dimensional deformity with helical rotation of the distal corporal bodies with the penile crurae remaining fixed to the pubic rami. The first case of congenital penile torsion (hypospadias) was described in 1857. Isolated penile torsion is an under-reported anomaly. The reported incidence of isolated penile torsion is 1.7-27% and severe torsion is 0.7%. There are no studies available from Indian subcontinent on the incidence of isolated penile torque. The objective of this study was to determine the overall incidence of isolated penile torque in a north Indian population.

Materials And Methods: A prospective study of deliveries of male children was conducted at our institute between April 2014 and June 2015. Penile torsion was measured using a small protractor either by the deviation of the median raphae or the direction of the meatus. Data were collected on the incidence of congenital isolated penile torsion, including the degree and direction (left or right) of torsion. Torsion was classified as mild (<450), moderate (450-900), and severe (>900). Statistical analysis was done using the chi-square test with variables of age and parity of the mother and weight of the child.

Results: There were 99 cases of isolated penile torque among 5018 male neonates assessed for penile torque. The incidence of isolated penile torque was 19.7 per 1000 births. The degree of torsion varied from 30 to 110° (average 51.46°). Seventy-nine percent (79%) of them had left side and 21% had right side torque (4:1). The degree of torsion was mild in 30%, with 20% having left side torque and 10% having right side torque (2:1). A moderate degree of torsion was seen in 69%: 84% of them had left torque and only 16% had right sided torque (5:1). Only one patient had severe left torque. The incidence of isolated congenital penile torsion was highest in the maternal age group of >30 years followed by the 26-30-year age group, and was lowest in 21-25 year age group. In multiparous women, the incidence of isolated congenital penile torsion was highest (2.54%), and it was lowest in primiparous women (1.36%).

Conclusion: The incidence of isolated penile torsion was 1.97% and the left-to-right ratio was 3:1, but for moderate torque it was 5:1. There was a strong association between incidence of penile torque with the age of the mother (p = 0.012) and parity (p = 0.008) but not with the weight of the baby (p = 0.415).
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http://dx.doi.org/10.1016/j.jpurol.2016.12.031DOI Listing
October 2017

Assessment of iron, folate and vitamin B12 status in severe acute malnutrition.

Indian J Pediatr 2015 Jun 24;82(6):511-4. Epub 2014 Oct 24.

Department of Pediatrics, RNT Medical College, Udaipur, 313001, Rajasthan, India,

Objectives: To assess iron, folate and vitamin B12 status in hospitalized children aged between 6 mo to 5 y with severe acute malnutrition and its correlation with their clinico-epidemiological profile.

Methods: The study was conducted on 50 children with severe acute malnutrition. Anthropometric measurements were taken to determine their nutritional status. The demographic profile and relevant information of individual patient were collected by using structured proforma and an informed consent was taken for enrolling the children into the study. Serum ferritin, folate and vitamin B12 was estimated using electrochemiluminiscence (ECL) method.

Results: Seventy eight percent patients had weight/height (WT/HT) Z score < -3 standard deviation (3SD), 72 % with mid upper arm circumference (MUAC) <11.5 cm and 22 % of them had edematous malnutrition. Anemia was prevalent in 47(94 %) and there was significant correlation between WT/HT < -3SD and vitamin B 12 deficiency (p = 0.015). Significantly higher number of these patients had vitamin B12 deficiency as compared to folate and iron deficiency (p = 0.0006 each).

Conclusions: Vitamin B12 deficiency was more common than iron and folate deficiencies in these patients with severe acute malnutrition.
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http://dx.doi.org/10.1007/s12098-014-1600-7DOI Listing
June 2015

Extrarenal calyces: a rare renal congenital anomaly.

Surg Radiol Anat 2015 May 17;37(4):407-10. Epub 2014 Jul 17.

Department of Anatomy, Postgraduate Institute of Medical Education and Research, Sector, 12, Chandigarh, 160012, India,

The congenital anomalies of urogenital system are not uncommon. The anomalies of renal collecting system form a complex subset of urogenital anomalies. Among these, extrarenal calyces are one of the infrequently found anomalies of the renal collecting system. Extrarenal calyces may be detected incidentally or when thoroughly investigated for its associated complications. We report two cases of extrarenal calyces characterized by the presence of major calyces and renal pelvis outside the renal parenchyma. The awareness of this anomaly can help in making the definitive preoperative diagnosis and prevent injury to pelvicalyceal system during surgery.
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http://dx.doi.org/10.1007/s00276-014-1349-8DOI Listing
May 2015