Papers by Mr. PRASHANT PATEL
African Journal of Urology, 2020
Background Urolithiasis in pregnancy is a major health concern and is one of the most common caus... more Background Urolithiasis in pregnancy is a major health concern and is one of the most common causes for non-obstetrical abdominal pain and subsequent hospital admission during pregnancy. The incidence of urinary calculi during pregnancy varies in the range of 1/200 to 1/2000. Acute ureteric colic in pregnancy is associated with significant potential risks to both mother and fetus. Significant anatomic and functional changes occur in pregnancy which not only lead to stone formation but also create diagnostic dilemma. The diagnosis of ureteric calculi can be incorrect in about 28% of pregnant patients. Main body Management of ureteric stone during pregnancy is remaining to be a challenge for the treating urologist. Because of the inability to use good imaging options for the diagnosis confirmation and more invasive approach for the treatment, management continues to be difficult. The main threats are preterm labor with delivery and premature rupture of membranes. Other pregnancy compl...
Journal of the American College of Cardiology, 2017
Background: In this study we utilize a population-based approach using electronic health record (... more Background: In this study we utilize a population-based approach using electronic health record (EHR) based algorithms to identify familial hypercholesterolemia (FH), a traditionally underdiagnosed and undertreated condition. We report the trends of major adverse cardiovascular events(MACE) and mortality associated with this diagnosis. Methods: In our 1.18 million EHR eligible cohort, International Classification of Disease (ICD)-defined hyperlipidemia was categorized into FH and non FH groups using a validated EHR algorithm designed using Dutch Lipid Clinic Network criteria. A priori associated variables/ confounders were used for multivariate analyses using binary logistic regression. Kaplan-Meier survival curves were created. Results: FH constituted 2.8% (32,609) of the entire EHR cohort and 12.6% of 258,045 patients with hyperlipidemia. FH had a higher incidence of CAD (26.2% vs 18% p<0.0001), MI (11% vs 5.6%, p<0.0001) and PAD (9.2% vs 5.6%, p <0.0001) and lower probability of survival (Figure 1). FH was a significant predictor of MACE (OR, CI, p-value: 2.13, 2.07-2.20, <0.01) or Death (1.24, 1.19-1.29, <0.01) after adjusting for traditional risk factors. Conclusions: EHR based algorithms discovered a disproportionately high prevalence of FH in our medical cohort, which was associated with worse outcomes. This data-driven approach allows for a more precise method to identify traditionally high risk groups within large populations allowing for targeted prevention strategies.
Journal of the American College of Cardiology, 2017
Background: Real time data on influence of cardiac devices in patients with heart failure with re... more Background: Real time data on influence of cardiac devices in patients with heart failure with reduced ejection fraction(HFrEF) is limited. Methods: We utilized National Readmission Data (NRD) 2013. HFrEF was identified using ICD 9 code (428.2x) as primary diagnosis. Considering modern cardiac
Journal of the American College of Cardiology, 2016
RESULTS All submassive patients survived (see table). Major complications included: 2 intracrania... more RESULTS All submassive patients survived (see table). Major complications included: 2 intracranial bleeds, 2 hematomas requiring evacuation, 2 access site complications requiring surgery, 2 pseudoaneurysms treated successfully with thrombin injection, 6 hematomas requiring transfusion, and 2 self-limiting GI bleeds requiring transfusion. Factors associated with complications were advanced age (p<0.01), massive PE presentation (p1⁄40.02), and IVC filter placement (p<0.01), but not total thrombolytic dose administered.
Journal of Surgical Case Reports, 2016
Primary prostate sarcomas are rare, reportedly comprising just 0.7% of all prostate malignancies.... more Primary prostate sarcomas are rare, reportedly comprising just 0.7% of all prostate malignancies. Here, we present the case of a 66-year-old man who was diagnosed with prostate stromal sarcoma after undergoing a routine transurethral resection of prostate for bladder outflow obstruction. Primary prostate sarcoma can be aggressive even when low-grade, with a high risk of local recurrence and, high malignant potential when high-grade. They require aggressive multimodality treatment with surgery, chemotherapy and radiotherapy for durable survival outcomes. They also require close surveillance with longterm follow-up.
Gastrointestinal endoscopy, Jan 28, 2016
Up to 6% of colorectal cancers (CRCs) are diagnosed within 5 years of a colonoscopy that did not ... more Up to 6% of colorectal cancers (CRCs) are diagnosed within 5 years of a colonoscopy that did not diagnose CRC (post-colonoscopy colorectal cancer, PCCRC). PCCRC and associated risk factors were examined within a national hospital episode database. A retrospective case-control study of all colonoscopies performed on adults recorded in Hospital Episode Statistics (HES) between 2003 and 2009 in England. PCCRC cases underwent colonoscopy 6 to 60 months before diagnosis; controls had not undergone colonoscopy 6 to 60 months before diagnosis. Multivariate logistic regression analysis examined associations with PCCRC. A total of 1,439,684 colonoscopies were analyzed, including 67,202 cases of CRC and 8147 cases of PCCRC (12.1%). Multivariate analysis revealed that female sex (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.08-1.19; P < .001), older age (70-74 years) (OR, 1.09; 95% CI, 1.00-1.18; P = .039), increased comorbidity (Charlson index 5+) (OR, 1.16; 95% CI, 1.05-1.28; P ...
SpringerPlus, 2016
Prompt diagnosis and early treatment for testicular cancer is vital. To help with this a one-stop... more Prompt diagnosis and early treatment for testicular cancer is vital. To help with this a one-stop, urologist run, testicular clinic with testicular ultrasound scanning as an integral part of the clinic format was introduced to investigate patients in an efficient and timely manner. The aim of this study was to assess the feasibility and efficiency of running a onestop testicular clinic. A prospectively collected electronic database of all patients attending a one-stop testicular clinic at a busy university hospital was interrogated over a 6-year period. Only new referral males, above the age of 15 years old were included. Case notes were reviewed retrospectively. A total of 1757 patients were found with a median age of 36. 6.3 % had a suspicious ultrasound scan and overall 5.6 % were found to have malignancy histologically. In addition a significant proportion of men with a history of testicular maldescent went on to develop testicular cancer (p < 0.01). Median time from referral to clinic and clinic to orchidectomy for suspected testicular cancers was 9 and 5 days respectively (95 % CI). Some of the benefits of a urologist run one-stop testicular clinic include: timely diagnosis and treatment, early reassurance with normal investigations, the discovery of clinically unsuspecting malignancy and the increase in teaching opportunities. These collective benefits must improve patient experience and benefit the department as a whole. A urologist led one-stop testicular clinic should be regarded as the gold standard.
SpringerPlus, 2015
Purpose: Orchalgia is a common problem with varicoceles however the association between varicocel... more Purpose: Orchalgia is a common problem with varicoceles however the association between varicocele embolisation for the treatment of varicocele related pain has not been widely investigated. We aim to investigate the effectiveness of varicocele embolisation for the treatment of orchalgia secondary to varicoceles; and to see if pre-embolisation pain scores can be used to predict treatment outcomes. Methods: A prospectively collected database of patients undergoing varicocele embolisation for pain was analysed over a 10-year period. Pain scores were assessed with a 10-point visual analogue score. Analgesia requirements and satisfaction scores were assessed with questionnaires. Results: Total of 96 cases. Median age was 34 years old. Median pain scores reduced significantly following embolisation (p < 0.001). 74% had reduced pain (30% of these had resolution of pain), 24% had no change in symptoms and 1% had worsening pain. Those with moderate or severe pain had a reduction of pain in 81 and 79% of cases respectively, however 64% of cases with mild pain did not experience any benefit. We also noted a reduction in analgesia requirements and a median satisfaction score of 8/10. Conclusion: Primary varicocele embolisation can successfully reduce varicocele related orchalgia. It works best in those with moderate or severe pain. The majority of patients with mild pain may not experience any benefit so should be counseled appropriately. The classification of patients into those with mild, moderate or severe symptoms prior to embolisation should be done, so robust consenting can be performed.
Urologic oncology, Jan 6, 2015
Castration-resistant prostate cancer (CRPC) has retained a guarded prognosis, with historical sur... more Castration-resistant prostate cancer (CRPC) has retained a guarded prognosis, with historical survival estimates of 18 to 24 months. However, the landscape of available therapy has changed, and the emphasis has altered from supportive to active treatment. Few large series from real-world populations exist in the contemporary era with fully mature survival data to confirm the indication based on clinical trials that patients with CRPC are surviving far longer than the historical estimates. We aim to review a large patient cohort with CRPC and provide mature survival data. Using the electronic histopathology database at Queen Elizabeth Hospital, Birmingham, UK, all prostate-specific antigentest results between April 2006 and September 2007 were extracted, and patients satisfying the American Society for Radiation Oncology (ASTRO) definition of hormone failure were identified. Electronic records were reviewed and variables were collected, including survival, treatment, biochemistry, hi...
International Journal of Research in Medical Sciences, 2015
Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobino... more Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS) in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal). Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease. Methods: The study covers a period of one year (January 2013-December 2013) and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat. Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male. Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease.
CardioVascular and Interventional Radiology, 2014
TheScientificWorldJournal, 2011
This review provides an overview of emerging techniques, namely, photodynamic diagnosis (PDD), na... more This review provides an overview of emerging techniques, namely, photodynamic diagnosis (PDD), narrow band imaging (NBI), Raman spectroscopy, optical coherence tomography, virtual cystoscopy, and endoscopic microscopy for its use in the diagnosis and surveillance of bladder cancer. The technology, clinical evidence and future applications of these approaches are discussed with particular emphasis on PDD and NBI. These approaches show promise to optimise cystoscopy and transurethral resection of bladder tumours.
SAE International Journal of Materials and Manufacturing, 2010
Piston design is a challenging engineering problem which involves complex physics and requires sa... more Piston design is a challenging engineering problem which involves complex physics and requires satisfying multiple performance objectives. Uncertainty in piston operating conditions and variability in piston design variables are inevitable and must be accounted for. The piston assembly can be a major source of engine mechanical friction and cold start noise, if not designed properly. In this paper, an analytical piston model is used in a deterministic and probabilistic (reliability-based) multi-objective design optimization process to obtain an optimal piston design. The model predicts piston performance in terms of scuffing, friction and noise, In order to keep the computational cost low, efficient and accurate metamodels of the piston performance metrics are used. The Pareto set of all optimal solutions is calculated allowing the designer to choose the "best" solution according to trade-offs among the multiple objectives. Our multi-objective optimization method is demonstrated with simple examples and applied in the design of an automotive piston.
Theoretical Biology and Medical Modelling, 2010
Background Ultrasound elasticity imaging provides biomechanical and elastic properties of vascula... more Background Ultrasound elasticity imaging provides biomechanical and elastic properties of vascular tissue, with the potential to distinguish between tissue motion and tissue strain. To validate the ability of ultrasound elasticity imaging to predict structurally defined physical changes in tissue, strain measurement patterns during angioplasty in four bovine carotid artery pathology samples were compared to the measured physical characteristics of the tissue specimens. Methods Using computational image-processing techniques, the circumferences of each bovine artery specimen were obtained from ultrasound and pathologic data. Results Ultrasound-strain-based and pathology-based arterial circumference measurements were correlated with an R2 value of 0.94 (p = 0.03). The experimental elasticity imaging results confirmed the onset of deformation of an angioplasty procedure by indicating a consistent inflection point where vessel fibers were fully unfolded and vessel wall strain initiated....
Prostate Cancer and Prostatic Diseases, 2004
Prostate cancer is the third most common cancer, accounting for one in 10 cancer diagnoses in men... more Prostate cancer is the third most common cancer, accounting for one in 10 cancer diagnoses in men worldwide during 2000. Despite this high burden of morbidity, there is a lack of curative treatments for locally advanced and metastatic disease. Good anatomical accessibility of the prostate combined with substantial molecular understanding of the disease makes prostate cancer an attractive target for gene therapy. Considerable progress has been made in the development of suitable gene transfer vectors and prostate-targeting strategies. Therapeutic approaches being explored fall into two broad categories: corrective and cytoreductive/cytolytic. There are currently 63 prostate cancer gene therapy clinical trials based on these approaches registered in the United States and United Kingdom. Although significant hurdles remain to be overcome, early clinical trial results are encouraging, suggesting that gene therapy may become an important treatment option for prostate cancer.
Journal of Applied Polymer Science, 1990
PRASHANT PATEL, TARULATA SHAH and BHIKHU SUTHAR, * Department of Chemistry, Sardar Pate1 Universi... more PRASHANT PATEL, TARULATA SHAH and BHIKHU SUTHAR, * Department of Chemistry, Sardar Pate1 University, Vallabh Vidyanagar 388 120, India ... Castor oil-a renewable resource-is abundantly grown in tropical countries. It is a triglyceride of glycerol and ricinoleic acid containing ...
Journal of Applied Polymer Science, 1989
Castor oil containing hydroxyl functionality was reacted with 4,4'-diphenylmethanediisocyanate un... more Castor oil containing hydroxyl functionality was reacted with 4,4'-diphenylmethanediisocyanate under different stoichiometric ratios of NCO/OH to obtain Liquid polyurethanes. These polyurethanes were subsequently interpenetrated with methyl acrylate monomer using ethylene glycol dimethacrylate as a crosslinker by radical polymerization using benzoyl peroxide as an activator. The polyurethane/poly(methyl acrylate) interpenetrating polymer networks (PU/PMA IPNsj were obtained as tough films by transfer molding techniques. All IPNs were characterized by their resistance to chemical reagents, optical properties, thermal behavior, and mechanical properties: tensile strength, Young's modulus, elongation at break (W) and hardness Shore A. The morphology of the IPNs was studied by scanning electron microscopy and dielectric properties: electrical conductivity (a), dielectric constant (E'), dielectric loss (e"), and loss tangent (tan 6) at different temperatures. oil + 4,4'-diphenyl methane diisocyanate) and methyl acrylate containing crosslinker. These IPNs were characterized by their resistance to chemical reagents, optical properties, thermal behavior (TGA), and mechanical properties. The morphology by scanning electron microscopy (SEM) and dielectric properties at different temperatures was studied.
International Journal of Surgery, 2013
who underwent laparoscopy in 2012 were identified retrospectively from a trauma database. Patient... more who underwent laparoscopy in 2012 were identified retrospectively from a trauma database. Patient injuries, imaging, operative findings, complications and length of stay were recorded. Results: 22 patients underwent a laparoscopy for penetrating abdominal injuries (21 knife-stabbings, 1 gunshot injury). Abdominal FAST scan was positive in 10/22 cases, of which 3 proceeded directly to surgery. Of the remainder, CT suggested intra-abdominal injury in 10 cases. 13/22 patients underwent therapeutic laparoscopy [repair bowel injury (4), diaphragm repair (1), haemostasis of liver (3), haemostasis of abdominal wall (4), reduction of omental herniation (1)] with two conversions to laparotomy. Laparoscopy revealed additional injuries to CT in 13/19 patients, however in the 7 cases of a negative CT, laparoscopy did not reveal additional injuries. Median LOS 2.5 days (range 0-31). No patients had post-operative complications/occult injury. Conclusion: Laparoscopic diagnosis and treatment for penetrating abdominal trauma appears to be safe in a specialised trauma unit and may reduce admission length.
BJU International, 2013
Review therefore, the exact prevalence is unknown. Treatment can be problematic, especially in el... more Review therefore, the exact prevalence is unknown. Treatment can be problematic, especially in elderly patients who may be frail and have comorbidities [4], and because the condition often responds inadequately to the usual symptomatic therapies. In severe cases, HC is associated with significant morbidity, prolonged hospitalisation and occasional mortality, and may require more aggressive measures, e.g. supravesical urinary diversion, vesical artery selective embolization, and cystectomy [5]. Furthermore, as the global burden of cancer is forecast to rise, primarily due to ageing and growth of the world's population [6], it is likely that the incidence of HC will rise too because of the increasing use of RT and chemotherapy. However, there is currently a lack of consensus about the best treatment for patients with chemical-and RT-induced HC, as well as a lack of UK-led guidelines available on how it should optimally be defined and managed. The aim of the present article is to review the predisposing risk factors for chemical-and RT-induced HC and the evidence for the different therapeutic and preventive measures that have been used to help clinicians better manage this potentially disabling condition. Methods A comprehensive literature search was undertaken in PubMed to retrieve studies and case reports, published in English, relating to the treatment of chemical-and RT-induced HC from 1980 to September 2012. The search was conducted using a comprehensive search strategy, including the terms 'haemorrhagic cystitis' , 'chemical cystitis' , 'radiation cystitis' in combination with 'risk factors' , 'chemotherapeutic drugs' , 'hyaluronic acid' , 'sodium hyaluronate' , 'hyperbaric oxygen' , 'mesna' , 'hyperhydration' , 'bladder irrigation' , 'pentosanpolysulphate' , 'oestrogen' , 'recombinant factor VII' , 'formalin' , and 'prostaglandin'. The search results were supplemented by review of the bibliographies of key articles for additional studies, inclusion of relevant abstracts presented at key meetings, as well as expert input, to help ensure the capture of all pertinent data.
Uploads
Papers by Mr. PRASHANT PATEL