Treatment with nanosomal paclitaxel lipid suspension versus conventional paclitaxel in metastatic breast cancer patients - a multicenter, randomized, comparative, phase II/III clinical study.

Background: A novel nanosomal paclitaxel lipid suspension (NPLS), free from Cremophor EL (CrEL) and ethanol, was developed to address the solvent-related toxicities associated with conventional paclitaxel formulation. Objective: To evaluate the efficacy and safety of NPLS versus CrEL-based paclitaxel (conventional paclitaxel) in patients with metastatic breast cancer (MBC). Design: A prospective, open-label, randomized, multiple-dose, parallel, phase II/III study. Methods: Adult (18-65 years) female patients with MBC who had previously failed at least one line of chemotherapy were randomized (2:2:1) to NPLS 175 mg/m2 every 3 weeks (Q3W, n = 48, arm A), NPLS 80 mg/m2 every week (QW, n = 45, arm B) without premedication or conventional paclitaxel (Taxol®, manufactured by Bristol-Myers Squibb, Princeton, NJ, USA) 175 mg/m2 Q3W (n = 27, arm C) with premedication. In the extension study, an additional 54 patients were randomized (2:1) to arm A (n = 37) or arm C (n = 17). Results: Pooled data from the primary study and its extension phase included 174 patients. The primary endpoint was the overall response rate (ORR). As per intent-to-treat analysis, ORR was significantly better in the NPLS QW arm as compared to conventional paclitaxel [44.4% (20/45) versus 22.7% (10/44), (p = 0.04)]. An improvement in ORR with NPLS Q3W versus conventional paclitaxel arm [29.4% (25/85) versus 22.7% (10/44)] (p = 0.53) was observed. Disease control rates observed were improved with NPLS Q3W versus conventional paclitaxel Q3W (77.7% versus 72.7%, p = 0.66) and with NPLS QW versus conventional paclitaxel Q3W (84.4% versus 72.7%, p = 0.20), although not significant. A lower incidence of grade III/IV peripheral sensory neuropathy, vomiting, and dyspnea was reported with NPLS Q3W versus conventional paclitaxel Q3W arms. Conclusion: NPLS demonstrated an improved tumor response rate and a favorable safety profile versus conventional paclitaxel. NPLS 80 mg/m2 QW demonstrated a significantly better response versus conventional paclitaxel 175 mg/m2 Q3W. Trial registration: Clinical Trial Registry-India (CTRI), CTRI/2010/091/001344 Registered on: 18 October 2010 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MjEzNQ==&Enc=&userName=CTRI/2010/091/001344), CTRI/2015/07/006062 Registered on: 31 July 2015 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTE2Mjc=&Enc=&userName=CTRI/2015/07/006062).

Role of nanosomal paclitaxel lipid suspension (NPLS) in the treatment of patients with metastatic breast cancer (MBC) Why was the study done? Paclitaxel is a commonly used drug for the treatment of breast cancer. Conventional formulation of paclitaxel is known to cause side effects like injection site reactions. A newer formulation named NPLS was developed to overcome the limitations of the conventional paclitaxel. The current study was done to compare the safety and effectiveness of NPLS and conventional paclitaxel in patients with advanced breast cancer. What did the researchers do? The research team conducted a large study in multiple hospitals across India, involving women with advanced breast cancer who had experienced treatment failure with previous chemotherapy. A total of 174 patients were randomly assigned to receive either of the three treatment schedules: (1) NPLS every 3 weeks, (2) NPLS every week, (3) conventional paclitaxel every 3 weeks. What did the researchers find? The results showed that NPLS, in a weekly schedule, led to better tumor response rates compared to conventional paclitaxel given every 3 weeks. Additionally, NPLS demonstrated a favorable safety profile, as compared to conventional paclitaxel. What do the findings mean? These findings suggest that NPLS could be a promising alternative for women with advanced breast cancer. NPLS improved the response to treatment, with a better safety profile compared to conventional paclitaxel.

Solitary Ileal Hemangioma in a 3-year-old Male.

Hemangiomas are rare small bowel tumors requiring a high index of suspicion for diagnosis. We present a case of ileal hemangioma in a 3-year-old male presenting with recurrent anemia. The patient was diagnosed with a contrast-enhanced computed tomography abdomen and managed surgically by resection and anastomosis. Histopathologically, it was a solitary ileal cavernous hemangioma with a submucosal infiltrative pattern with serosa involvement and a normal mucosa.

Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015-2017 Korean National Environmental Health Survey.

Increased liver enzymes as a result of exposure to mercury and their toxic effects are not well understood in Korea at the population level. The effect of blood mercury concentration on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was evaluated after adjusting for sex, age, obesity, alcohol consumption habit, smoking, and exercise parameters in 3712 adults. The risk of abnormal liver function was measured using a multiple logistic regression analysis. Blood mercury concentration was divided into quartiles, and liver enzyme levels were compared for each quartile. ALT and AST levels were 10-20% higher in the second, third, and fourth quartiles compared to the first quartile. The risk of liver dysfunction or elevated liver enzymes was significantly higher in the second, third, and fourth quartiles than in the first quartile. As blood mercury levels increased, liver enzymes and mercury-induced hepatotoxicity increased. The increase in liver enzymes caused by mercury was more pronounced in the low-mercury concentration range. To reduce the long-standing problem of abnormal liver enzymes and liver function in Korea and other similar settings, it is important to decrease exposure to mercury through effective implementation of specific health and environmental strategies.

Profile of Ectopic Pregnancy Cases in a Tertiary Hospital.

BACKGROUND: An ectopic or extra uterine pregnancy is one in which the blastocyst implants anywhere other than the endometrial lining of the uterine cavity. The objective of the study was to find incidence, risk factors, clinical presentation and mode of management of ectopic pregnancy. METHODS: Observational study was conducted at Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu. All the relevant data were recorded in performa. The collected data were entered in MS Excel and exported into SPSS 26 version for statistical analysis. RESULTS: About one third of the patients 10 (33.3%) was of 25-29 age group.The most common risk factor was pelvic infection in 23 (76.6%) cases, abortion in 11 (36.7%), and abdominal surgery in 8 (26.7%) of cases. The of classic triad of amenorrhea (100%), pain abdomen (99.7%) and per vaginal bleeding (66.7%). Ruptured ectopic seen in 26 (86.7%) cases, unruptured status in 1 (3.3%) case, tubal abortion in 1(3.3%) case and organized ectopic in 2(6.7%) cases. The most common site was found to be ampulla in 23 (76.7%) cases, fmbria 3(10%) cases, corneal in 3(10%) cases and ithmus in 1 (3.3%) case. All the cases managed surgically, of them unilateral salphingectomy, unilateral salphingo-opherectomy and wedge resection for corneal pregnancy were done in 25(83.3%), 2(6.7%) and 3(10%) cases respectively. CONCLUSIONS: Ectopic pregnancy mostly present as ruptured form in young females in our context. Pelvic infection is the commonest risk factor with ampulla being the commonest site. All cases required surgical intervention in form of unilateral salphingo-opherectomy and wedge resection.

Ovarian Carcinoma in a Young Pregnant Woman.

Ovarian cancer during pregnancy is a rare event. Little is known about the treatment of this condition due to the lack of randomized trials and cohort studies. A case of 28 years female, from Kathmandu, visited Out-Patients Department with complaint of amenorrhea for 8 weeks associated with nausea and occasional pain abdomen. Dating scan was done which showed a single live intrauterine pregnancy corresponding to 8 weeks 4 days of gestation with incidental finding of adnexal cysts in both adnexa, measuring 3.6 x 3.6 cm on right and on left 3.2 x 3.6 cm. The cysts did not show any septations. At 38 weeks, she underwent caesarean section and delivered a healthy baby girl. Intra-operatively, bilateral ovarian cysts were identified, both 2x2 cm simple-looking cysts. Enucleation of bilateral ovarian cysts was done. The specimen was sent for histopathology which showed serous carcinoma of low grade in bilateral ovaries. Staging surgery was then carried out after 6 weeks. Histopathology report showed serous carcinoma of low grade in both ovaries. We present here the case of ovarian cancer during pregnancy. Keywords: Ovarian cancer; pregnancy.

Deep versus superficial erector spinae block for modified radical mastectomy: A randomised controlled pilot study.

BACKGROUND AND AIMS: Forero et al. described two approaches of erector spinae (ES) plane block: superficial and deep to erector spinae muscle. We hypothesised that the superficial technique would not lead to optimum analgesia as the drug would have to cross one more muscle layer. We aimed to compare the techniques in terms of analgesia and sensory blockade in patients undergoing modified radical mastectomy (MRM). METHODS: Forty American Society of Anesthesiologists (ASA) I/II female patients in age group 18-60 years undergoing unilateral MRM were included in this prospective study. Group D patients received 20 mL 0.2% ropivacaine deep to erector spinae at the T4 level. Group S patients received 20 mL 0.2% ropivacaine superficial to erector spinae. Sensory level of block, perioperative opioid consumption, and adverse effects were noted. RESULTS: Twenty four hours morphine consumption was less in group D: 5.47 ± 1.1 mg and in group S was 7.66 ± 0.74 mg (P < 0.001). The sensory spread was more in deep group in the posterior axillary and mid axillary line. There were no reported adverse effects in either group. CONCLUSION: Injection of drug deep to ES muscle provides more cranio-caudal blockade of posterior and lateral chest wall, hence providing better analgesia following breast surgery. Injection of the drug superficial to the muscle leads to inferior analgesia.

Microencapsulation of stearic acid with SiO2 shell as phase change material for potential energy storage.

Stearic acid (SA) is being used as phase change material (PCM) in energy storage applications. In the present study, the microencapsulation of SA with SiO2 shell was carried out by sol-gel method. Different amounts of SA (5, 10, 15, 20, 30 and 50 g) were taken against 10 ml of tetraethyl orthosilicate (TEOS) for encapsulation. The synthesized microencapsulated PCM (MEPCM) were characterized by Fourier transform infrared spectroscope (FT-IR), X-Ray diffraction (XRD), X-Ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). The characterization results showed that SA was successfully encapsulated by SiO2. Thermogravimetric analysis (TGA) exhibited better thermal stability of the MEPCM than SA. The enthalpy values of MEPCM were found to be unchanged even after 30 heating-cooling cycles by differential scanning calorimetry (DSC). The latent heats of melting and solidification of 50 g SA containing MEPCM were found to be highest i.e. 182.53 J/g and 160.12 J/g, respectively among all microencapsulated samples. The encapsulation efficiency values were calculated using thermal data and the efficiency was found to be highest i.e. 86.68% in the same sample.

Effect of Phosphate-Based Inhibitor on Corrosion Kinetics and Mechanism for Formation of Passive Film onto the Steel Rebar in Chloride-Containing Pore Solution.

In the present study, different contents, i.e., 1-3% of 0.5 M ammonium phosphate mono basic (APMB), were used as corrosion inhibitor to reduce the corrosion of steel rebar. Electrochemical impedance spectroscopy (EIS) results showed that up to 24 h of exposure, polarization resistance (Rp) and passive/oxide film resistance (Ro) gradually decreased in simulated concrete pore (SCP) + 3.5 wt.% NaCl solution owing to the reduction in pH of the solution. The steel rebar exposed in 2% inhibitor containing SCP + 3.5 wt.% NaCl solution exhibited 90% inhibition efficiency after 1 h of exposure. X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy confirmed the formation of thermodynamically very stable and sparingly soluble goethite (α-FeOOH), maghemite (γ-Fe2O3), and iron phosphate (FePO4) as passive/oxide film onto the steel rebar surface exposed to 2% inhibitor containing SCP + 3.5 wt.% NaCl solution.

Ammonium Phosphate as Inhibitor to Mitigate the Corrosion of Steel Rebar in Chloride Contaminated Concrete Pore Solution.

In the present study, different amounts, i.e., 1-3 v/v% of 1 M ammonium phosphate monobasic, were used as an eco-friendly corrosion inhibitor to mitigate the corrosion of steel rebar exposed to simulated concrete pore (SCP) + 3.5 wt% NaCl solution at a prolonged duration. Potentiodynamic polarization results show that as the amount of inhibitor is increased, the corrosion resistance of steel rebar is increased. The steel rebar exposed to 3% inhibitor-containing SCP + 3.5 wt% NaCl solution exhibited nobler corrosion potential (Ecorr), the lowest corrosion current density (icorr), and 97.62% corrosion inhibition efficiency after 1 h of exposure. The steel rebars exposed to 3% inhibitor-containing SCP + 3.5 wt% NaCl solution revealed higher polarization resistance (Rp) and film resistance (Ro) with exposure periods compared to other samples owing to the formation of passive film. The scanning electron microscopy (SEM) of steel rebar exposed to 3% inhibitor-containing SCP + 3.5 wt% NaCl solution showed homogenous and uniform dendritic passive film which covers all over the surface, whereas, bare, i.e., SCP + 3.5 wt% NaCl solution exposed samples exhibited pitting and irregular morphology. Raman spectroscopy results confirm the formation of goethite (α-FeOOH), maghemite (γ-Fe2O3), and iron phosphate (FePO4) as a passive film onto the steel rebar surface exposed to 3% inhibitor-containing SCP + 3.5 wt% NaCl solution. These phases are responsible for the corrosion mitigation of steel rebar which are very protective, adherent, and sparingly soluble.

Tracheostomy: Open Surgical or Percutaneous? An Effort to Solve the Continued Dilemma.

Due to lack of globally standardized guidelines and clarity on indications, patient selection, intra-operative preparations, technique, complications, postoperative care and decannulation protocols, percutaneous tracheostomy (PT) has come in vogue as compared to standard open surgical tracheostomy (OST). PercuTwist and guide wire dilatational method (GWDF), techniques of PT, offer lesser operative time and ease of surgery being a bedside procedure. There seems to be paucity of Indian literature on rising trend of increasing indications, post-operative care, management of complications and outcomes of tracheostomy. And thus, there arises a felt need to envisage a study in tertiary care setup targeting these issues and to question the so far unchallenged acceptance of new techniques and technology. Our aim is to study the recent trend of indications, complications, and outcomes of both OST and PT in a cohort of Indian patients who underwent tracheostomy. 80 patients with mean age of 59.0 ± 15 years underwent tracheostomy (OST: 48 (60%), PT: 32 (40%), and among PT, PercuTwist: 16 (50%), GWDF: 16 (50%)) for various indications with objectives to compare operative time, complications and decannulation rates of tracheostomy surgery, within the follow up period of 3 months. Most common indication of elective tracheostomy was prolonged ventilation, and for emergency ones, upper airway obstruction. Mean operative time taken by all the three techniques was comparable, i.e., 16.3 v/s 15 v/s 15.3 min (Open v/s PT GWDF v/s PT PercuTwist). Most common intra-operative complication of OST was haemorrhage (16.3%) and that of PT was false passage (8.8%). Early post-operative complications were haemorrhage (OST: 3.75%, PT: 1.25%) and tube blockage and dislodgement (equal distribution among OST and PT). Late post-operative complications were stomal granulations in PT: 7.5%. Outcomes of tracheostomy were significantly better with OST (36 (45%)) than PT (14 (17.5%)). In PT group, PercuTwist fared better than GWDF in terms of lesser complications (PercuTwist: 10%, GWDF: 18.6%) and better decannulation rates (PercuTwist: 13.6%, GWDF: 3.75%). Most common indication for tracheostomy remains prolonged intubation; complication of OST is intra and early post-operative haemorrhage and that of PT being tube dislodgement and blockage. Outcomes in form of successful decannulation are with OST.

Corrosion Characteristics of Copper-Added Austempered Gray Cast Iron (AGCI).

The aim of this investigation was to assess the corrosion behavior of gray cast iron (GCI) alloyed with copper. Alloyed GCI specimens were austempered isothermally at varying temperatures. After austenitizing at 927 °C, the samples were austempered at different temperatures ranging from 260 to 385 °C with an interval of 25 °C for 60 minutes. As a result, these samples developed an ausferrite matrix with different percentages of austenite. The resulting microstructures were evaluated and characterized by optical microscope (OM), scanning electron microscope (SEM), and X-ray diffraction (XRD). The corrosion characteristics were determined using potentiodynamic polarization tests and electrochemical impedance spectroscopy (EIS) of these samples. These tests were carried out in a medium of 0.5 M H2SO4 and 3.5% NaCl solution. It was observed from the potentiodynamic polarization results that with increasing austempering temperature, the corrosion rate decreased. All results of the EIS were in accordance with a constant phase element (CPE) model. It was found that with an increase in austempering temperature, the polarization resistance (Rp) increased. The austenite content was also found to influence the corrosion behavior of the austempered gray cast iron (AGCI).

Optimization of Micro and Nano Palm Oil Fuel Ash to Determine the Carbonation Resistance of the Concrete in Accelerated Condition.

The carbonation rate of reinforced concrete is influenced by three parameters, namely temperature, relative humidity, and concentration of carbon dioxide (CO2) in the surroundings. As knowledge of the service lifespan of reinforced concrete is crucial in terms of corrosion, the carbonation process is important to study, and high-performance durable reinforced concretes can be produced to prolong the effects of corrosion. To examine carbonation resistance, accelerated carbonation testing was conducted in accordance with the standards of BS 1881-210:2013. In this study, 10⁻30% of micro palm oil fuel ash (mPOFA) and 0.5⁻1.5% of nano-POFA (nPOFA) were incorporated into concrete mixtures to determine the optimum amount for achieving the highest carbonation resistance after 28 days water curing and accelerated CO2 conditions up to 70 days of exposure. The effect of carbonation on concrete specimens with the inclusion of mPOFA and nPOFA was investigated. The carbonation depth was identified by phenolphthalein solution. The highest carbonation resistance of concrete was found after the inclusion of 10% mPOFA and 0.5% nPOFA, while the lowest carbonation resistance was found after the inclusion of 30% mPOFA and 1.5% nPOFA.

Prevalence of behavioral risk factors of cardiovascular diseases and associated socio-economic factors among pregnant women in a rural area in Southern Nepal.

BACKGROUND: Cardiovascular diseases (CVDs) have dramatically infiltrated populations living in abject poverty in Low- and Middle-income Countries (LMICs), and poor maternal and child health outcomes have been frequently reported for those with CVD risk factors. However, few studies have explored the behavioral risk factors of CVDs among pregnant women in rural settings. This study aimed at determining the prevalence and identifying the socio-economic predictors of behavioral risk factors of CVDs among pregnant women in rural area in Southern Nepal. METHODS: A Community-based cross-sectional study was conducted in 52 clusters of Dhanusha District of Nepal in a total of 426 pregnant women in their second trimester using multistage cluster sampling method. Multivariable logistic regression model was used to assess independent associations between behavioral risk factors during pregnancy and maternal socio-economic characteristics. RESULTS: Of the 426 study participants, 86.9, 53.9, 21.3 and 13.3%, respectively, reported insufficient fruits and vegetables consumption, insufficient physical activity, tobacco use, and harmful alcohol drinking. Socio-economic factors significantly associated with more than one behavioral risk factors in expectant mothers with a primary level education (adjusted odds ratio (AOR) 2.78; 95% Confidence Interval (CI) (1.35-5.72)), 20-34 years age group (Adjusted Odds Ratio (AOR) 0.27; 95% CI (0.13-0.56)), and those with the highest wealth index (AOR 0.36; 95% CI (0.16-0.84)). CONCLUSION: Higher prevalence of behavioral risk factors for CVDs and their socio-economic factors prevailing among pregnant women living in rural Nepal call for immediate health promotion interventions such as community awareness and appropriate antenatal counseling.

Protection of Reinforced Concrete Structures of Waste Water Treatment Reservoirs with Stainless Steel Coating Using Arc Thermal Spraying Technique in Acidified Water.

Waste water treatment reservoirs are contaminated with many hazardous chemicals and acids. Reservoirs typically comprise concrete and reinforcement steel bars, and the main elements responsible for their deterioration are hazardous chemicals, acids, and ozone. Currently, a variety of techniques are being used to protect reservoirs from exposure to these elements. The most widely used techniques are stainless steel plating and polymeric coating. In this study, a technique known as arc thermal spraying was used. It is a more convenient and economical method for protecting both concrete and reinforcement steel bar from deterioration in waste water treatment reservoirs. In this study, 316L stainless steel coating was applied to a concrete surface, and different electrochemical experiments were performed to evaluate the performance of coatings in different acidic pH solutions. The coating generated from the arc thermal spraying process significantly protected the concrete surface from corrosion in acidic pH solutions, owing to the formation of a double layer capacitance-a mixture of Cr3+ enriched with Cr2O3 and Cr-hydroxide in inner and Fe3+ oxide on the outer layer of the coating. The formation of this passive film is defective owing to the non-homogeneous 316L stainless steel coating surface. In the pH 5 solution, the growth of a passive film is adequate due to the presence of un-dissociated water molecules in the aqueous sulfuric acid solution. The coated surface is sealed with alkyl epoxide, which acts as a barrier against the penetration of acidic solutions. This coating exhibits higher impedance values among the three studied acidic pH solutions.

Arsenic Exposure and Haematological Derangement in Cervical Cancer Cases in India.

Cervical cancer is the second most common gynecological malignancy worldwide. According to HPV Information Centre, Spain (Aug'2014), in India approximately 1,22,844 women are diagnosed with the disease every year and of them 67,477 die due to the disease. CaCx is said to be mediated by HPV but recent data published reveal the role of Oxidative Stress in different Cancers. Arsenic is also one of the agents for causing Oxidative Stress. Arsenic has been linked with different types of cancer. Arsenic is considered responsible for generation of free radicals and eventually for apoptosis. Early diagnosis of CaCx is presently a matter of concern and clinical presentation in advanced stages become difficult for complete clinical response. For determination of oxidative stress, Malondialdehyde (MDA) was taken as an identifier and arsenic estimation was performed with the help of Atomic Absorption Spectrometer (AAS). RBC count and Haemoglobin levels were performed according to standard protocol. MDA was in direct proportion with arsenic concentration and inversely proportional to RBC and Haemoglobin in CaCx patients. Arsenic is one of the major causative agents for oxidative stress and hence may be a risk factor leading to cancer including CaCx.

Percutaneous retrieval of coiled double-J stent from renal pelvis after Anderson-Hynes pyeloplasty: report of two cases.

Double-J (DJ) ureteral stents are routinely placed for internal urinary diversion post renal pyeloplasty. Malfunction of the stent may occur due to migration, necessitating removal. Upward migration of a DJ stent is rarely encountered in urologic practice when a ureteroscope is used to retrieve the stent. However, retrieval of upwardly migrated stents through ureteroscopy may be challenging in the pediatric population, especially in postoperative cases. We report two pediatric cases of post Anderson-Hynes pyeloplasty in whom the DJ stents were found coiled up in the renal pelvis and were retrieved successfully through percutaneous nephrostomy using semirigid bronchoscopic forceps.

Multicystic dysplastic kidney in children--a need for conservative and long term approach.

OBJECTIVE: We retrospectively studied our cases of Multicystic Dysplastic Kidney (MCDK). The review was aimed at identifying the pattern of the disease in Indian Scenario and the required management thereof. METHODS: We studied the clinical, radiological and nuclear scan findings of 22 patients with unilateral MCDK. They were diagnosed and/or treated in our unit from 1999 to 2007. The diagnosis was achieved by Ultrasound and further confirmed by DMSA scans. Other ancillary investigations like Micturating cystourethrogram were done if indicated. These patients were followed and followup investigations consisted of renal ultrasound, blood pressure measurement, and urinalysis and blood biochemistry RESULTS: A total of 22 patients (18 boys and 4 girls) with unilateral MCDK were investigated and followed for a mean period of 41 months. MCDK was detected on antenatal ultrasound only in 12(55%) and postnatally in 10(45%) babies. Mean age for postnatal diagnosis was 20 months. Follow up ultrasound revealed complete involution of MCDK in 3 patients and partial regression in 11 patients. The size of dysplastic kidney was unchanged in 4 patients and a further 4 patients underwent nephrectomy. Indications of nephrectomy were parental anxiety in 2, hypertension in 1 and palpable mass in 1. CONCLUSION: Large proportion (45%) of patients in presented series are diagnosed post natally contrary to western world where more than 80% are diagnosed antenatally. Uncomplicated isolated MCDK carry good prognosis with nephrectomy required in only a few patients. Association with other urological anomalies in ipsilateral/contralateral genitourinary tract is important to identify as they have worse outcome in terms of ultimate renal function. All patients with simple/complex unilateral MCDK should be advised long term follow up for the possible development of hypertension and/or hyper infiltration injury.