ABSTRACT
Background and Objectives: Catheterization related urethral injury (CRUI), particularly in men, is common and produces significant morbidity. However, it seems to have gathered little interest of concerned authorities towards prevention. The objective of the study is to reveal that many CRUI are usually due to improper technique.Material and Methods: This is a retrospective and descriptive study carried out at Janaki Medical College & Teaching Hospital, Janakpur between May 2013 and September 2016. It included 18 male patients presenting in emergency with acute CRUI. Re-catheterization was attempted by experienced surgeons in them unless there was history suggestive of urethral stricture and the outcome was analyzed.Results: Mean age of the patients was 62.9 ± 17.7 (range: 22 - 90) years. When the consultant attended them, 8 (44.4%) patients had catheter in place with intraurethral balloon inflation (IUBI), and 10 patients had catheter removed. One patient in each group had scrotal hematoma suggesting urethral perforation. Excluding two patients with typical history suggestive of urethral stricture, manual urethral re-catheterization was attempted by surgeon in 16 patients and succeeded in 12 (75%) patients, which was remarkable. Rest of the 6 patients had suprapubic catheterization.Conclusion: Most of the CRUI results from technical fault and are potentially preventable.
ABSTRACT
Background and Objectives: Lamotrigine is a “second generation” anti-epileptic drug (AED) approved by the Food and Drug Administration (FDA) and is the first FDA-approved therapy after Lithium for maintenance treatment of bipolar I disorder. It crosses the placenta easily indicating that the maternal treatment leads to a considerable fetal exposure. This study is planned to study the morphological and histological changes induced by Lamotrigine in the fetal rat brain. Material and Methods: The morphological effect of lamotrigine on fetal rat brain was studied after giving four times its recommended therapeutic dose to 12 pregnant rats and placebo to 6 control rats during the period of organogenesis. The rats were sacrificed on the twentieth day of pregnancy. Body weight, body length, brain weight, brain volume, histological examination of the cerebral cortex and ventricular size of all the delivered fetuses were studied. Non-parametric Mann-Whitney test was used to compare the data. Results: There was no significant difference in mean body weight, mean body length, mean brain weight and mean brain volume in control and experimental rat fetuses. However one lamotrigine exposed rat fetus had exencephalic malformation and its histological study of the cerebral cortex revealed ill defined plexiform layer and dilated lateral ventricle. Conclusion: Probability that lamotrigine produces congenital malformation in fetal rats, when used during pregnancy, is low.