Vaginal Laser Therapy for Stress Urinary Incontinence:A Systematic Review of Prospective Randomized Clinical Trials

The most common type of urinary incontinence in women is stress urinary incontinence (SUI) which negatively impacts several aspects of life.The newly introduced vaginal laser therapy is being considered for treating SUI. This systematic review aimed to evaluate the efficacy of vaginal laser therapy for stress urinary incontinence in menopausal women. We searched the following databases: MEDLINE (via PubMed), EMBASE, Cochrane Library databases, Web of Science, clinical trial registry platforms, and Google Scholar, using the MeSH terms and keywords [Urinary Incontinence, Stress] and [(lasers) OR laser]. In our systematic review, prospective randomized clinical studies on women diagnosed with SUI as per the International Continence Society’s diagnostic criteria were included. The Cochrane Risk-of-Bias assessment tool for randomized clinical trials was used to evaluate the quality of studies. A total of 256 relevant records in literature databases and registers and 25 in additional searches were found. Following a review of the titles, abstracts, and full texts, four studies involving 431 patients were included. Three studies used CO2-lasers, and one used Erbium: YAG-laser. The results of all four studies revealed the short-term improvement of SUI following both the Erbium: YAG-laser and CO2-laser therapy. SUI treatment with CO2-laser and Erbium: YAG-laser therapy is a quick, intuitive, well-tolerated procedure that successfully improves incontinence-related symptoms. The long-term impact of such interventions has not been well established as most trials focused on the short-term effects.

Progression of disease in extra hepatic biliary atresia is associated with reduced total hepatic blood flow: descriptive results of a prospective pilot study

Hepatic fibrosis and cirrhosis develop progressively in extrahepatic biliary atresia despite timely surgical intervention. We aimed to study total hepatic blood flow [hepatic artery and portal vein flow] as a possible predictive factor of outcome of infants having biliary atresia who had underwent Kasai portoenterostomy. Twenty Infants having biliary atresia underwent colored and pulsed Doppler ultrasound studies. They were done before and 2-3 months after portoenterostomy. Hepatic artery, portal vein and single hepatic vein mean flow, mean diameter, mean velocity, hepatic arterial to portal venous flow ratio and total hepatic flow/kg were calculated and correlated to final outcome. The detected mean total hepatic flow and total hepatic flow/kg preoperatively was 685.5 +/- 296 ml/min and 147.1 +/- 51.4 ml/min/kg and post-operatively in those who became anicteric was 854.4 +/- 107 ml/min and 149.5 +/- 37.2 ml/min/kg, 539.2 +/- 337.7 ml/min and 112.1 +/- 78.6 ml/min/kg in those who developed chronic disease and in those who died was 157.6 +/- 79.6 and 30.9 +/- 16.1 ml/min/kg respectively. Unresolving cholestasis in infants having biliary atresia with poor outcome following portoenterostomy is associated with decreased post-operative total hepatic flow. Preoperative total hepatic flow did not correlate with postoperative total hepatic flow

Serum vitamin A in children with persistent diarrhea

To explore the relationship between vitamin A status and persistent diarrhea, the present study was carried out on 25 cases with persistent diarrhea and 10 age and sex matched controls, chosen from the gastroenteritis clinic C.U.P.H. over a period of 6 months. They included 20 males and 15 females, ages ranged from 2 months to 3 years. Full clinical examination was performed. Laboratory investigations included stool analysis and culture, and estimation of serum vitamin A by high performance liquid chromatography [HPLC]. 17/25 cases [68%] showed low serum vitamin A, in 11/25 cases [44%] serum vitamin A was <0.2 mg/L, while in 6/25 cases [24%] serum vitamin A was <0.1 mg/L. The mean serum vitamin A for cases [0.18 +/- 0.09] was lower than controls [0.35 +/- 0.10] with a statistically significant difference [P <0.01]. No correlation was observed between serum vitamin A and age, sex, weight or feeding pattern of patients. The only significant correlation was observed between serum vitamin A and diarrheal duration. The longer the duration of diarrhea, the lower is the serum vitamin A [r = -0.566 P <0.05]