Clinic outcome evaluation of tamsulosin therapy for benign prostatic hyperplasia

To evaluate the clinical outcome of the once daily oral dose of tamsulosin [0.4 mg] for managing clinical benign prostatic hyperplasia [BPH], a total of 157 out of 186 patients completed the 6-month follow up study protocol. All cases had a bothersome international prostate symptom score [IPSS] of more than 7 and peak flow rate [PFR] of less than 12 ml/second with no absolute surgical indications. The efficacy assessment variables included monitoring IPSS, peak flow rate [PFR] and post-voiding residual volume [PVR] for six months through five outpatients clinic visits [initial, two weeks, six weeks, three months and six months]. The clinical outcome was satisfactory in 124/157 patients with documented improved IPSS and/or PFR. An unsatisfactory outcome occurred in 33/157 patients; 19 showed no improved IPSS and/or PFR, 11 were unsatisfied and decided to undergo surgery and 3 developed acute urinary retention which was persistent and required to undergo surgery. Adverse effects occurred in 21/157 patients including dizziness in 6/157 patients, asthenia in 8/157, abnormal ejaculation in 11/157, rhinitis in 4/157 and severe adverse effects necessitating drug withdrawal in 3/157 patients

value of MR imaging of the bone marrow in children with haematopoietic malignancies

Malignancies were examined by MRI to detect the bone marrow changes. They were 44 patients with acute leukaemia, 4 patients with chronic myelogenous leukaemia, 4 patients with Hodgkins lymphoma, 3 patients with non. Hodgkin s lymphomta and 2 patients with polycythaemia vera. MRI proved to be highly sensitive in detection of focal or dtffuse bone marrow changes in 52 patients [Sensitivity: 100%] and to exclude any bone marrow affection in 5 patients [Specificity: 100%]. In spite of its high sensitivity in detection of bone marrow pathology, MRI could not defive a certain disease. In all haematopoietic malignancies, MRI revealed focal or diffuse low signal intensity on T1 -weighted images and high signal intensity on T2-weighted images. MRI-guided bone marrow biopsy was performed in 26 patients. All were successful and augmented the MRI diagnosis of persistence or relapse of the disease [19 patients], bone marrow aplation with fat replacement [4 patients] and secondary post therapy myelofibrosis [3 patients]. MR1 was proved to be very valuable tool in follow up of patients and in detection of the therapy complications. Its use should restrict the need for bone marrow biopsy to one time at the initial diagnosis

Computed tomography versus magnetic reasonance imaging in diagnosis of congenital cystic intracranial lesions

Twenty one cases of congenital cystic intracranial lesions [having a range of age 24 days to 15 years] were subjected to CT and MRI examinations. The imaging findings were compared with the final diagnosis obtained by clinical data, operation and follow up. The lesions appeared mostly as hypodense nonenhancing masses of CSF density by CT, exerting mass effect according to the size and no surrounding edema. By MRI, they appeared hypointense in T1WI and hyperintense in T2WI. The pathological varieties encountered were; 2 cases of holoprosencephaly, 2 hydranencephaly, one porencephaly, 8 Dandy walker [DW] complex, 7 arachnoid cysts, and one epidermoid tumour. Both CT and MRI can give similar informations concerning the size, shape, rim thickness and other morphologic characteristics of cystic intracranial lesions. Additional data given by MRI are; superior visualization of cerebellar vermis in cases of Dandy Walker complex hence it could be classified into [type A] with absent vermis and [type B] with present vermis in the axial MRI cuts for the fourth ventricular level. MRI is better for detection of infection in an arachnoid cyst by the presence of high signal intensity inside the cyst, It is also able to predict the nature of the contents of the epidermoid cyst whether protein or triglycerides according to its signal intensity in both T[1] and T[2] WI. MRI can detect abnormal signal intensity in the cyst wall of a porencephalic cyst that helps differentiation from arachnoid cysts. Also MRI has a better performance specially in posterior fossa lesions as it is not affected by beam hardening artifact as CT. Other advantages of MRI include lack of ionizing radiation and direct visualization of blood flow, Muliplanar capability and high soft tissue resolution. CT is superior to MRI in the detection of calcification in certain lesions as epidermoid cyst

Pancreatic duct dilatation in pancreatic carcinoma and chronic pancreatitis: a CT study

CT of the pancreas was done for 20 patients with normal pancreata, 32 with pancreatic carcinoma and 14 with chronic pancereatitis. Their ages ranged from 35-76 years. Dilated pancreatic duct was demonstrated in 66% of patients with carcinoma and 57% of patients with chronic pancreatitis. It was found that a pancreatic duct to gland width ratio of 0.5 or more suggests carcinoma while intraductal stones suggest chronic pancreatitis as the underlying cause. The study confirms the association of pancreatic ductal dilatation in pancreatic carcinoma and chronic pancreatitis. However, as an isolated findings, pancreatic ductal dilatation only confirms the presence of pancreatic disease but no specific etiology can be suggested and further studies should be initiated to clarify the underlying cause