Lower urinary tract symptoms evaluation with uroflowmetry in patients with benign prostatic hyperplasia

Background: Uroflowmetry, a non-invasive urodynamic technique, is commonly employed in evaluating patients with potential lower urinary tract dysfunction. Accurate assessment of the severity of lower urinary tract symptoms (LUTS) can be achieved through the utilization of various validated questionnaires, such as the International Prostate Symptom Score (IPSS). The objective of this study was to investigate the correlation between uroflowmetry parameters and the severity of symptoms. Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation from May 2022 to December 2023. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Significant statistical correlations were identified between the IPSS and uroflowmetry outcomes, including peak flow rate, average flow rate, and post-void residual urine. However, no correlation was observed between the IPSS and measurements of prostate volume. Conclusions: A positive correlation was observed between the measured peak flow rate through uroflowmetry and the severity of lower urinary tract symptoms.

Tale of spontaneous passage of large proximal ureteric calculus in a male patient

Ureteric stones are very notorious. Sometimes a very small stone may require a surgical removal and sometimes a large stone might pass spontaneously. We report a case of a 43 years old male patient who presented to our department with complaint of right flank pain of 1-week duration. This patient was diagnosed with right proximal ureteric calculus (11�mm) at L3 level. He was planned for ureterorenoscopy lithotripsy (URSL)/push back percutaneous nephrolithotomy (PCNL). Patient needed time for getting financially prepared for the surgery. Meanwhile we prescribed him an alpha blocker once daily at bedtime, oral analgesia SOS and advised to take adequate hydration. On 10th day of first presentation, to our surprise, the patient came with a stone in his hand, which he has passed spontaneously, and was confirmed by a radiograph. The likelihood of a ureteric stone spontaneously passing during expectant treatment is influenced by various factors, including its size, location, and orientation within the ureter. 11�mm proximal ureteric stone is the largest stone passed spontaneously in a male patient in our institute and most probably in literature.

Clinical Study of Cardiac Autonomic Dysfunction and QT Dispersion in Newly Diagnosed HIV Positive Individuals and its Correlation with CD4 Count

Background: HIV is a global pandemic with an estimated 38 million People Living with HIV (PLHIV) worldwide. Autonomic nervous dysfunction is seen more frequently in PLHIV and Cardiac autonomic dysfunction affects severely the quality of life in them. Early detection of autonomic neuropathy helps in the rehabilitation of PLHIV. Objectives: To evaluate the presence and extent of cardiac autonomic dysfunction and QT dispersion in newly diagnosed PLHIV, and To correlate autonomic with CD4 count. Method: Age and sex-matched Case-control study was conducted in the hospitals attached to Bangalore Medical College and Research Institute (BMCRI). 30 patients (15 HIV positive with AIDS and 15 HIV positive without AIDS) and 30 healthy controls who gave consent for the study and satisfied the inclusion and exclusion criteria were enrolled in the study. Cardiac autonomic function was assessed by Ewing’s battery of autonomic function tests and QT dispersion was measured. Statistical analysis was performed using SPSS software for Windows and a p-value <0.05 was considered significant. Results: Abnormal cardiac autonomic function was observed in 20% of patients with AIDS and 6.6% of patients without AIDS. There was statistically significant differences observed between PLHIV and controls for systolic blood pressure fall on standing (p=0.02), heart rate response to deep breathing (p=0.017), to standing(p=0.004), and to Valsalva maneuver(p=0.035). 33.3% of PLHIV had abnormal QT dispersion. Conclusions: Increase in the severity of cardiac dysautonomia was seen as the CD4 counts reduced to <200 cells/microL.QT dispersion is an important predictor of cardiac autonomic dysfunction. Autonomic function tests should be performed for early detection of cardiac dysautonomia which is an important contributor to mortality and morbidity in PLHIV.

Aquarium granuloma: a diagnosis based on history

Mycobacterium marinum infections are rare but well described in literature. It causes an infection known as aquarium granuloma or swimming pool granuloma since its transmitted through contaminated water. We describe a case of aquarium granuloma in a male patient with skin nodules over his dominant hand whose occupational history helped clinch the diagnosis.

A swelling on the fore head- the tip of the iceberg.

An epidermoid cyst is a benign cyst usually found on the skin, developing out of ectodermal tissue. These are relatively uncommon benign cysts or tumors to arise over the surface of the brain. They are mostly intra dural and few percentages are located in the diploic space. We are reporting a case of 51 years old lady presenting with a swelling over forehead which was diagnosed to be an intradiploic epidermoid cyst of the frontal bone with an intracranial extension which is an unusual presentation causing clinical dilemma. Radiological findings led to a correct diagnosis and with complete removal patient is doing well.

rare case of isolated eyelid myxoma

Myxoma is a benign neoplasm derived from primitive mesenchyme usually occurring in heart but can arise rarely in orbit, eyelid and conjunctiva. A 9-year-old boy presented with a history of right eye lower lid lesion of two year duration. The patient had undergone excision of the lesion at a private hospital. Two months later patient developed a recurrence. Examination showed a soft non tender multinodular skin coloured lesion of 1.25 x1 cm dimension on the medial aspect of the right lower eyelid extending on to the conjunctival side without any involvement of the lower fornix or the lacrimal punctum. Visual acuity was 6/6, N6. Rest of the anterior segment was within normal limits. Wide excision of the lesion along with lid margin and lid reconstruction with direct closure a lateral cantholysis was done. Histopathology of the excised lesion showed features suggestive of myxoma with a prominent vasculature. Detailed cardiac and dermatological evaluation did not show other components of Carney's complex. Isolated eyelid myxoma is an extremely rare condition with a tendency towards local recurrence following incomplete excision

Sneaky pancreatic head mass

A 60 yrs old male presented to the Father Muller Medical College and Hospital, India, with dyspeptic symptoms. On physical examination, epigastric tenderness was present and ultrasound revealed an ill defined in homogeneous hyper echoic lesion in the head of pancreas. Hemogram, serum amylase, serum lipase and liver function tests were all normal. Contrast-enhanced CT showed a homogeneous focal mass measuring about 5x6 cm in the pancreatic head, [Figs, la and b]. The mass was isodense with fat tissue, with interlobular septa, and without central or peripheral contrast. Upper GI endoscopy revealed mild antral gastritis. The patient improved with antacids

comparative study on fine needle aspiration cytology versus fine needle capillary cytology in thyroid nodules

Fine needle aspiration cytology [FNAC/FNA] is the primary investigation for thyroid nodules. Fine needle capillary cytology [FNCC/FNC] is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis. This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules [diagnosed by palpation] were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available [38 cases]. The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia. The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC