ABSTRACT
Febrile seizures are the most common neurologic disorder in the pediatric age group, affecting 2–5% of children between 6 months and 5 years of age in the United States and Western Europe with a peak incidence between 12 and 18 months. Although febrile seizure is seen in all ethnic groups, it is more frequently seen in the Asian population (5–10% of Indian children and 6–9% of Japanese children). Systemic inflammatory response has been implicated as a contributor to the onset of febrile seizure [1]. It is studied that IL-B, IL-6, TNF-ALPHA can play an important role in generation of febrile seizure. Although they are the useful biomarkers, its availability in day to day practice is very limited. So there is a need for low cost and widely used inflammatory response markers like NLR, MPV, PLT, and RDW as independent predictors of febrile seizure and to compare different Hematological parameters in febrile seizure in patients with an unclear seizure history. The 5 novel indices of inflammatory response: i. Neutrophil Lymphocyte Ratio ii. Mean Platelet Volume iii. Platelet Count Ratio iv. Red cell Distribution Width v. Serum Ferritin The study is carried out for the assessment of other hematological parameters in febrile seizures like HB, RBC, PCV, RDW, Platelets, MPV and PCR. Also to compare the variation of hematological parameters in simple and complex febrile seizures based on the laboratory parameters which are otherwise classified clinically.
ABSTRACT
Background: Benign prostatic hyperplasia (BPH) is the commonest urological condition affecting men over 50 years of age. Medical therapy is usually the first line management of BPH. Finasteride is a 5-alpha reductase inhibitor (5ARI), which blocks the conversion of testosterone into the more potent dihydrotestosterone (DHT). Materials and methods: We prospectively enrolled 54 BPH patients with prostate size ranging from 30-60 gm based on ultrasound, who were undergoing elective TURP at Gandhi Hospital for a period of 2 years from January 2013 to Jan 2015. BPH patients with hematuria, bothersome symptoms and refractory retention were included in the study. Results: Totally 54 BPH patients were enrolled in our study, 30 were randomized to finasteride group and 24 to controlled group. There was significantly less (p value <0.01) mean blood loss in irrigation fluid in the finasteride group compared to the control group (54.27 gm in finasteride group Vs 82.45gms in the control group; p value < 0,01) for each transurethral resection of prostate. Conclusion: Finasteride give daily for 2 weeks before transurethral prostate resection decreased bleeding preoperatively, thereby decreasing the requirement of blood transfusions, post operative episodes of hematuria and clot retention.
ABSTRACT
Introduction: Urethral stricture is a common condition with varying etiology and management, determined by cause, site and length of stricture. Materials and methods: We presented here a randomized prospective trial comparing dorsal onlay buccal mucosa graft and penile skin flap urethroplasty at our institute over 3 years period. Results: Total 22 patients underwent substitution urethroplasty during this period. The mean age and follow up was 31.31 years and 9 months respectively. The most common cause of stricture urethra was post inflammatory (40.90%) followed by traumatic (36.36%) and balanitis xerotica obliterence (22.72%). Majority had combined penobulbar stricture (45.45%), followed by penile (31.81%) and bulbar (22.7%). The average size of the urethral stricture was 6.81 cm. The most common symptom of presentation of stricture urethra was thin stream (100%) followed by dysuria (80%), frequency (71.42%) and dribbling (30%). Most of the patients underwent surgical procedure prior to presentation; urethral dilatation done in 13 (59.05%) patients followed by visual internal urethrotomy 7 (31.81%) patients and suprapubic cystostomy in 4 (18.18%) patients. Of 22 patients, 10 (45.45%) underwent local flap and 12 (54.54%) patients buccal mucosal graft. Out of 10 local flap technique, 8 (36.36%) patients underwent ventral longitudinal flap and 2 (9.09%) underwent Quartey flap. Out of 12 buccal mucosal graft technique, 5 (22.72%) patients underwent ventral onlay graft, 5 (22.72%) dorsal onlay and 2 (9.09%) tube circumferential graft. Total success rate was 72.72%. Success rate was higher with buccal mucosal graft (83.33%) compared to local flap technique (60%). Among local G. Mallikarjuna, N. Ramamurthy, G. Ravichander, Ravi Jahagirdar, Jagadeeshwar. Substitution urethroplasty: Buccal mucosal graft Vs local flaps - A prospective randomized study. IAIM, 2016; 3(10): 162-173. Page 163 flap technique, ventral longitudinal flap (62.5%) had better results than quartey flap (50%). Among buccal mucosal graft dorsal onlay graft had best (100%) results followed by ventral onlay (80%) and then tube circumferencial graft (50%). Patients with smaller stricture length (2.5-7.5 cm) had better (75%) results. Patients with combined penobulbar (90%) and BXO as etiology (80%) also had better results. Conclusion: The success rate of buccal mucosal free graft substitution urethroplasty is better than local penile skin flaps in patients with anterior urethral strictures.