A Study to Evaluate the Efficacy of Alfuzosin in Clearance of Distal Ureteric Calculi

Introduction: Urinary stone disease is a major health problemnot only because of high prevalence but also because it affectsthe young and productive population of the society. The currentstudy was performed to assess and compare the expulsiveeffects of orally administered Afluzosin as medically expulsivetherapy for distal ureteral calculi less than 8 mm in diameterwhen administered upto 21 days after the first painfulmanifestation.Materials and Methods: A total of 60 patients with distalureteric calculi were enrolled in the study and were divided intwo groups. The control group comprised of 30 patients withdistal ureteric calculi who were given Cap. Becosule (Vitamin BComplex) (Placebo) once a day for clearance of ureteric calculiwith plenty of fluids and analgesics as and when required. Thestudy group comprised of 30 patients with distal ureteric calculiwho were given Tab. Alfuzosin hydrochloride 10 mg once aday for clearance of ureteric calculi with plenty of fluids andanalgesics as and when required. The outcome was measuredin terms of passage of calculi, no. of days taken for passage ofcalculi and no. of analgesic tablets consumed until passage.The statistical analysis was done using chi-square test forproportions and Independent samples "t" test for comparingmeans between the two groups and a p value less than 0.05indicated statistically significant difference.Results: In study group, stone was passed within 21 days ofstudy period in 26 (86.7%) subjects whereas in control group, itcould pass in only 14 (46.7%) patients thus showing asignificant statistical difference between two groups (p=0.001).Mean analgesic intake was 6.63±1.38 tablets in study groupand 8.63±3.26 tablets in control group, thus showing that themean analgesic intake was significantly high in control groupas compared to study group (p=0.009).Conclusion: In our study Patients in Alfuzosin groupdemonstrated a higher incidence of spontaneous stonepassage, more rapid stone passage and a decreased need foranalgesic. This selective α1 blocker should therefore beincluded in different schedules used worldwide, when aconservative approach to this very common urological problemis considered.

A Clinico- Epidemiological Study Of Hydronephrosis At Era`S Lucknow Medical College, Lucknow

Hydronephrosis is defined as aseptic distension of the renal calyces and pelvis with urine as a result of partial obstruction of the outflow of urine. It is a clinical condition which is caused by dilatation of the renal collecting system most frequently caused by incomplete or complete obstruction. Although this condition is quite common yet its incidence and prevalence, aetiology, diagnosis and management is less commonly reported in literature especially in context with adults and non-pregnant women. This prospective study was conducted to evaluate the etiology, classify causes of hydronephrosis and to study common clinical presentation of Hydronephrosis. hydronephrosis was seen as a highly male dominant disease with renal calculi as the major aetiology and BPH and VUR being age-associated risk factors. Aetiology based management of hydronephrosis yielded good outcome. The present study is perhaps the first detailed clinco-pathological profile of hydronephrosis.

Neurotuberculosis as a Cause of Obesity.

Childhood obesity, taking the form of pandemic in the present era owing to the food habits, lifestyle etc, is the main cause of adult onset diseases. Obesity is the major risk factor for insulin resistance and diabetes, hypertension, cancer, gall bladder disease, and atherosclerosis in adulthood. Obesity being multi-factorial various genetic, anatomic, environmental factors are implicated to its etiognesis. While evaluating the causes of obesity in a child, in addition to the common causes, diseases involving hypothalamus should not be overlooked. We are discussing here a 9 year male child who reported to us for obesity and neurotuberculosis as the etiology was established.

Atypical neuroleptic malignant syndrome. “Doing more harm than gain”.

Neuroleptic malignant syndrome (NMS) a rare, idiosyncratic, and potentially fatal adverse reaction can be deceptive especially when the hallmark features are lacking. Most diagnostic criteria include fever and muscle rigidity, although NMS may present without either. Delirium, agitation and catatonia can be the earliest features of NMS and in acute care settings, concomitant use of sedatives and anti-psychotics by the attending clinicians may even obscure the sentinel signs of NMS and further aggravate the underlying insult. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment and the strict adherence to the classical criteria of NMS may lead to a diagnostic delay and dire consequences for these patients and sometimes this delay can procure death.

Early Anticoagulation Post LSCS in a Symptomatic Cortical Venous Thrombosis with Protein - S Deficiency.

Post partum cerebral venous sinus thrombosis (CVT) in a high risk predisposed individual and its management particularly after a major surgical intervention i.e. lower segment caesarean section (LSCS) is debatable. Guidelines are there to treat after 72 hours of major surgical intervention. We report a case of CVT with generalised tonic clonic seizures as a life threatening complication in whom anticoagulation was started at 48 hours post LSCS without any complications of anticoagulation. We recommend early anticoagulation despite major surgical intervention, so as to avoid the impending life threatening complications following cerebral venous thrombosis in predisposed individuals.