Sonographic correlations between intravesical prostatic protrusion and bladder outlet obstruction in patients with symptomatic benign prostatic hyperplasia in Ibadan, Nigeria

Evaluating bladder outlet obstruction (BOO) in patients with prostatic enlargement may reflect the severity of the disease and aid in predicting the treatment outcome. Objectives: To determine the sonological correlation between intravesical prostatic protrusion and bladder outlet obstruction in patients with symptomatic benign prostatic enlargement. Methods: This prospective study was conducted over one year at the Department of Radiology, University College Hospital, Ibadan. A transabdominal ultrasound scan of the urinary bladder and prostate gland was carried out on patients with prostatic enlargement and BOO. The intravesical prostatic protrusion, pre-and post-void urine volumes, prostate volume and bladder wall thickness were measured. Results: A total of 132 men aged 43 to 90 years (mean age: 63.8±8.64 years) were studied. The median size of the intravesical prostatic protrusion (IPP) was 7.25 mm (IQR: 0.00 mm; 14.9 mm). The mean prostate volume was 63.3ml±36.0ml. Most subjects (55; 41.7%) had a prostate volume above 60ml, and most patients (101, 77.2%) had bladder wall thickness less than 5mm. The mean bladder wall thickness was 4.26mm±1.54mm. There was a statistically significant correlation between IPP and pre-void urine volume and prostate volume (p = 0.002 and <0.001, respectively). Patients over 70 years had increasing IPP and post-void urine, which lacked statistical significance (p =0.15). Conclusion: The severity of bladder outlet obstruction was reflected in the pre-void urine volume, which correlated with the size of IPP

Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Keny

Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures. Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.

Epidemiology of urinary tract infections in the children in zagazig university children's hospital

Background: The most common bacterial infection among children is Urinary Tract Infection (UTI). Early diagnosis and good treatment of UTI is very important as the risk of renal damage is increased in children below the age of five years which result of morbidity. The aim of this study was to estimate the prevalence of urinary tract infection (UTI) in children attending Pediatric outpatient clinic in Zagazig University Children's Hospital. Also to determine related risk factors, isolate the organisms that cause UTI in children and antibiotics susceptibility patterns. Methods: This Cross sectional descriptive study, was conducted on 600 children, (377 males and 223 females) from two to seven years old attending to pediatric outpatient clinic ZUH , All patient groups were exposed to full medical history, physical examination, Dipstick analysis by using both nitrite and leukocyte esterase detector, Microscopic examinations and urine culture for positive cases.Results: The prevalence of UTI between children included in the current study was (7%). LE positive were 56 (9.3%), Nitrite positive were 47 (7.8%) and both LE and Nitrite positive were 17 (2.8%). Conclusion: The prevalence of UTI was 7 % in our study, E - Coli was detected to be the most common organism, Cefotaxime and Amikacin were detected to be the most common antibiotic sensitive to the isolates

Comparison of Urine Culture and Urine Dipstick Nitrite Test in Diagnosis of Urinary Tract Infection

UTI is one of the most frequent bacterial diseases in all group of the age. The most widespread reference method for UTI is conventional urine culture. Dipsticks nitrite test is commonly used in primary care to predict the subsequent diagnosis of urinary tract infection also it helps in early detection of UTI by avoiding the complication of UTI in causing other diseases. The current study was carried out to determine the sensitivity; specificity of Nitrite (NIT) testing in relation to urine culture. A total of 1043 mid stream urine samples from patients who attend KFH; Kigali; at the microbiology service for bacteriological analysis of urine from January 2014 to March 2014 were included in the study. Urine culture and dipstick tests were carried out on urine samples of all patients. Urinalysis and nitrite were performed in fresh and uncentrifuged urine by using urine dip stick. The urine culture was considered as gold standard. Urine cultures were positive in 165 (15.8) patients. Dipstick tests of urine were positive in 61(5.8) patients. Sensitivity; specificity; positive predictive value (PPV) and negative predictive value (NPV) of Dipstick test were 36.6; 99.9 and 87.8 respectively. The results suggest that any method of urine screening shouldn't be substituted for a urine culture in patient with suspicion of UTI

Effect of instructions about the method of urine collection and storage on the isolation rate of urinary bacteria in children

A study of 65 children (29males and 36females) and aged between four weeks and 15years with significant bacteriuria was undertaking over a six month period to determine the effects of instruction received about the methods of urine collection and storage on the prevalence of urinary tract infection. The commonest clinical presentation was fever (64.6). Only 22(35.4) of the patients had specific symptoms suggestive of urinary tract infections. The instructions about urine collection were given to 48(73.8) care givers. This instruction was given by the attending doctors (84). Despite the explanation; 15(23.1) of the patients collected the urine samples wrongly and 44(67.7) stored the samples for longer than one hour. Significant bacteriuria was more prevalent in 74.2of patients who submitted their urine samples more than one hour after collection. Communication skill is important and should be emphasized in the trainings of health workers in procedure on the patients

Antibiogram of Klebsiella Pneumoniae urinary isolates of apparently healthy individuals in Osogbo Metropolis; Nigeria

One thousand (1;000) urine samples from apparently healthy subjects were cultured for Klebsiella pneumoniae and its antibiotic susceptibility profile to commonly used antimicrobial drugs was determined. The study was conducted in two randomly selected local government areas within Osogbo metropolis. The occurrence rate of Klebsiella pneumoniae was 38 (3.8) and isolate were highly resistant to Tetracycline (92.1); Amoxyllin (76.3) and Co-trimoxazole (71.9). Resistance to gentamicin was moderate (63.2) while Ofloxacin; nitrofurantoin; ciprofloxacin; nalidixic acid and pefloxacin were very effective with 92.1; 84.2; 78.9and 76.3respectively sensitive to it and Cephalexin (57.9) was moderately sensitive. More females

Candiduria in HIV Infected Patients in Yaounde; Cameroon

Objective: To detect Candida species in the urine of patients living with human immuno-deficiency virus (HIV); and correlate the presence of candiduria and CD4 counts. Patients and Methods: The study population consisted of 105 hospitalized patients from the Military and Central Hospitals of Yaounde; who either were HIV positive or already suffering from AIDS. The patients consisted of 63 females (60) and 42 males (40) giving a male to female ratio of 1:1.5. Midstream urine samples were collected from all patients and mycological examination of the centrifuged sediments was done. Patients with CD4 counts 499 lymphocytes/mm3 were a proxy control group. Results: 38 of 105 (36.2) subjects had candiduria. 71of the cases were asympto-matic. The percentage of patients positive versus negative for candiduria increased progressively from stage-A (5) to B (32) to C (63) HIV infection. There was thus a correlation between candiduria and the CDC disease stage. Its presence heralded an advanced immuno-suppressed state of the AIDS patient. Conclusion: In resource-poor communities; where viral copy and CD4 count determination are expensive; candiduria may serve as one of the indicators for anti-retroviral therapy. We recommend routine detection of candiduria in this high-risk group of HIV/AIDS patients

Protéinurie et syndrome néphrotique de l'adulte dans le service de néphrologie de l'unité d'hémodialyse de l'hôpital du Point G :à propos de 65 cas

Le syndrome néphrotique est une affection assez fréquente dans le monde en général et dans les pays sous-développés en particulier, lié au bas niveau socio-économique. En Afrique, en particulier au Mali, plusieurs facteurs interviennent dans la pathogénie de la maladie modifiant son aspect caricatural. Nous avons réalisé une étude rétrospective portant sur un échantillon de 65 patients âgés de 15 à 63 ans. L'objectif était d'étudier la protéinurie au cours du syndrome néphrotique de l'adulte, afin de déterminer les aspects quantitatifs, les signes cliniques et biologiques associés et les aspects thérapeutiques. Il ressort que la protéinurie était supérieure à 3g/24h dans 70,76% des cas, comprise entre 1 et 3 g/24 h dans 21,54% des cas et entre 0,5 et 1g/24h dans 7,69% des cas. Les signes cliniques étaient plus fréquents chez les patients présentant une protéinurie supérieure à 3g/24h. Quant aux signes biologiques, ils étaient diversement observés selon le taux de protéinurie. Le traitement spécifique de la protéinurie a consisté en une corticothérapie, utilisée dans 93,85% des cas, seule ou associée aux IEC et aux immunosuppresseurs. Le traitement non spécifique a fait appel aux IEC dans 6,15% des cas

Serum and Urine Levels of Zinc and Selenium in Diabetics in Calabar; Nigeria

The study aimed to determine the serum and urine zinc (Zn) and selenium (Se) in diabetics and non-diabetics in Calabar; Nigeria. Fasting plasma glucose (FPG); urine creatinine and serum and urine zinc and selenium levels were determined in 60 diabetic subjects aged between 35-75 years and 40 age-matched non-diabetic subjects using colorimetric methods and Atomic Absorption Spectrometry. The FPG; urine Zn and Se levels were significantly higher and serum Zn and urine creatinine levels lower in diabetics than those of non-diabetics. No significant difference was observed in the serum Se levels of both groups. A significant positive correlation (p 0.01) was observed between serum Zn and serum Se (r

Urodynamic assessment of sacral root neuromodulation in patients with intractable storage and voiding dysfunctions

Objective Sacral root neuromodulation is becoming one of the standard options for the treatment of intractable voiding dysfunction. The current report presents the urodynamic changes supporting the subjective improvement achieved by sacral root neuromodulation in patients with both voiding and storage problems. Patients and Methods Out of 50 patients being candidates for peripheral nerve evaluation (PNE) for various voiding and storage problems; 38 patients agreed to be subjected to urodynamics before; during and after subchronic PNE. Seventeen patients presented with an urgency-frequency syndrome; 9 with urge incontinence and 12 with chronic idiopathic urinary retention. All patients had failed to respond to various previous oral and intravesical treatments. The protocol included a four-day voiding diary and urodynamics before; during and after subchronic PNE. Results Significant changes in the urodynamic results of the patients during PNE were noted. Urodynamics of the urge incontinence and urgency-frequency patients showed an increased volume compared to the first urge cystometric bladder capacity after sacral root neuromodulation. The cystometrograms of patients with chronic idiopathic urinary retention did not show any difference during PNE when compared to the pre-PNE tests. Pressure-flow studies that were not possible before PNE became normalized during PNE. The urodynamics of all patients one week after PNE showed variable degrees of deterioration. The urodynamic findings of 7 patients who had an implantation of permanent programmers still showed the same results as after PNE testing. Conclusion There is a definite correlation between both subjective and objective improvement of patients on neuromodulation proved by urodynamic studies. However; this needs to be further evaluated as a predictor for success

Antibiotics Susceptibility Patterns of Urine Bacterial Isolates in Zaria; Nigeria

PURPOSE: The prevalence of E. coli; Ps. aeruginosa and Staph aureus isolates from urine of selected residents in Zaria was investigated. This was an attempt to elucidate the antibiotic susceptibility profiles of these bacteria commonly implicated in urinary tact infection. METHODS: Urine samples collected from students of Faculty of Pharmaceutical Sciences; Ahmadu Bello University and Kaduna State Polytechnic; Zaria; Nigeria; commercial sex workers; and illiterate men and women in Zaria were cultured and bacterial isolates identified using standard microbiological procedures. The antibacterial susceptibility of the isolated bacteria were investigated. RESULTS: A total of 206 bacteria were isolated from 150 urine samples collected from the subjects. The prevalence of the Ps aeruginosa; Staph aureus and E. coli isolates from the urine samples is 53.4 percent; 43.3 percent and 40.7 percent; respectively. Commercial sex workers had the highest (30.6 percent) prevalence of bacteria in their urine samples while the students had the least. Multiple antibiotics resistance was highest for the bacteria isolates obtained from urine samples of the students and commercial sex workers. CONCLUSION: Ps aeruginosa; Staph aureus and E. coli are highly prevalent in urine of the residents of Zaria investigated. The high multiple antibiotics resistance identified makes it necessary for antibiotic susceptibility testing to be conducted prior to antibiotics prescription in in Zaria

Etude de la prevalence de la proteinurie et de la glycosurie chez les jeunes recrues de la classe 2000-2A de l'armee Ivoirienne: a propos de 1979 cas

OBJECTIF: Connaitre la prevalence de la proteinurie et de la glycosurie chez les recrues des forces armees nationales de cote d'ivoire (FANCI) de janvier 2003.MATERIELS ET METHODES : Notre travail est une etude descriptive transversale qui a porte sur 1979 recrues. Cette etude a consiste au depistage de la proteinurie et de la glycosurie par des bandelettes reactives de type URICHECK sur les differents lieux d'entrainement.RESULTATS*Au plan sociodemographique:-la moyenne d'age des enroles est 24;62 ans avec des extremes de 18 et 34 ans.-le groupe ethnique majoritaire est le groupe KWA (42;54pour_cent); suivi du groupe KROU (38;75pour_cent).-la plupart des appeles travaillent dans le secteur informel (53;57pour_cent); s'ils ne sont pas chomeurs (29;10pour_cent) ou eleves et etudiants (17;33pour_cent).*Au plan clinique-L'indice de Pignet qui mesure la robustesse des appeles a permis d'exempter 161 enroles.-l'indice de masses corporelles IMC a permis de detecter 5;6pour_cent des sujets ayant un surpoids et 0;61pour_cent d'obeses.-la hernie ombilicale a ete revelee dans 0;8pour_cent des cas.*Au plan biologique :La proteinurie :-la proteinurie globale a ete trouvee dans 3;3pour_cent alors que la proteinurie significative superieure a une croix etait de 0;45pour_cent-cette proteinurie est independante de l'age; du groupe ethnique de la region d'origine; de l'activite professionnelle; de l'indice de masses corporelles et de l'indice de Pignet-ces chiffres sont nettement en dessous de ceux de Konan qui a trouve 4;5pour_cent de proteinuries significatives sur un effectif de 1000 enfants ages de 10 a 18 ans.La glycosurie :-la prevalence de la glycosurie globale est de 1;5pour_cent.-la frequence de la glycosurie potentiellement pathologique (deux croix et plus) etait de 0;25pour_cent.-cette glycosurie est independante de l'age; du groupe ethnique; de la region d'origine; de l'activite professionnelle; de l'indice de masse corporelle et de l'indice de Pignet.CONCLUSION : Le couple glycosurie; proteinurie dont la recherche est indispensable dans les criteres d'enrolement en Cote d'ivoire; gagnerait a etre analysee dans des conditions optimales pour une interpretation plus objective

Examen microscopique urinaire normal de l'adulte zairois aux Cliniques Universitaires de Kinshasa

Les objectifs ont ete de proposer une methode standardisee de l'examen microscopique de l'urine et de determiner les valeurs de reference. Cent dix-neuf echantillons recoltes lors de la premiere et/ou de la seconde miction matinale provenant de 100 sujets sains. Les urines etaient d'aspect limpide chez tous les sujets et de coloration jaune clair (58;80 pour cent); jaune fonce (27;7 pour cent) (jaune paille (13;4 pour cent). L'urine de la premiere et de la seconde miction constitue l'echantillon ideal pour l'examen microscopique urinaire. Les valeurs de reference obtenues sont comparables a celles rapportees dans la litterature. Ces resultats suscitent l'interet de la vulgarisation de la methode standardisee

Interet de la cytologie urinaire dans le diagnostic des cancers vesicaux. [Lettre]

La cytologie urinaire est un examen non invasif; utile dans le diagnostic et dans la surveillance des tumeurs des voies extra-urinaires notamment vesicales. Cette etude retrospective a porte sur 151 prelevements d'urine provenant exclusivement du service d'Urologie du CHU de Cocody et adresses au Laboratoire de Cytologie de la Faculte de Medecine de 1980 a 1990. 20 dossiers (13;2 pour cent) ont ete retenus sur un seul critere: la presence de cellules malignes ou suspectes dans le prelevement urinaire. Au plan epidemiologique; les 20 malades etaient tous des adultes; dont la moyenne d'age etait de 52;8 ans. Le sexe masculin etait predominant (85 pour cent). La symptomatologie dominee par l'hematurie (100 pour cent) etait souvent associee a des lombalgies; une pollakiurie et/ou une dysurie (14 cas sur 20). Des oeufs de bilharzies n'ont pas ete retrouves. Au plan clinique; les diagnostics les plus souvent evoques etaient: les tumeurs vesicales (60 pour cent) et les tumeurs prostatiques avec extension vesicale (20 pour cent). Au plan cytologique; parmi les 20 prelevements retenus; 13 etaient des carcinomes evidents (carcinomes epidermoides vesicaux) et 7 ont paru suspects. L'examen histologique realise dans 7 cas (35 pour cent); a permis de confirmer 5 diagnostics cytologiques (71;42 pour cent) et de deceler 2 faux negatifs (28;57 pour cent). Les correlations cytoclinique: 91 pour cent et cyto-histologique: 71;4 pour cent etaient satisfaisantes pour les cancers vesicaux dans cette etude et ont permis aux auteurs de conclure que l'examen cytologique des urines dans la pathologie tumorale vesicale; demeure un moyen d'investigation fiable et sensible. Il apparait cependant important de sensibiliser les medecins et les auxiliaires de la sante; au bon conditionnement des prelevements afin d'eviter les problemes d'interpretation lies aux alterations cellulaires

Chromatographie des acides amines urinaires chez l'enfant malnutri en Cote d'Ivoire

L'etude chromatographique des acides amines urinaires chez l'enfant malnutri a abouti aux constatations suivantes : le tryptophane pourrait etre considere comme un indicateur biologique de la malnutrition proteino-calorifique (M.P.C.); la triade tryptophane-isoleucine-arginine semble caracteriser les MPC et egalement les cas de deces dus a cette affection