ABSTRACT
Introduction: Inguinal lymph nodes are the commonest siteof penile metastasis whose incidence varies from 50% to 70%depending on the stage of disease . To differentiate reactionaryto metastatic lymph node fine needle aspiration cytology, trucut needle biopsy and dissection of inguinal lymph node hasbeen used. We tried to evaluate sono-elastography features ofinguinal lymph node in cases of Carcinoma Penis. Study aimedto evaluate sono-elastography, B-mode ultra-sonography andtheir combination for characterization of palpable inguinallymph node in patients of carcinoma penis.Material and method: 34 lymph node evaluated with sonoelastography for elastogram and strain ratio, B-mode ultrasonography and their combination which were compared withtrucut needle biopsy taken as gold standardResults: The overall sensitivity, specificity and accuracyof B-mode ultra-sonography, sono-elastography and theircombination is 78%, 82%, 86%; 84%, 80%, 81% and89%, 73%, 79% respectively. Sensitivity and specificity ofelastography strain ratio by taking 2.3 as cutoff is 89.5% and86.7% respectively.Conclusion: US elastography appears to be a promising toolfor differentiating benign and malignant lymph nodes. Furtherstudies are needed to fully standardize the clinical applicationof this technique with large sample size at multiple centers.
ABSTRACT
Introduction: The ureteral stent placement has become a partof urological clinical practice to relieve ureteral obstructioncaused by variety of urological condition since 1967. Studyaimed to access the role of anticholinergic (Tolterodine),uroselective α 1D/1A blocker (Naftopidil) alone and incombination to evaluate DJ stent related discomfort or pain,lower urinary tract symptoms and impact on quality of life.Materials and methods: This was a randomized double blindplacebo controlled comparative prospective clinical studyconducted between May 2013 to February 2015 to access therole of anticholinergic (Tolterodine), uroselective α 1D/1Ablocker (Naftopidil) alone and in combination to evaluate DJstent related discomfort or pain, lower urinary tract symptomsand impact on quality of life.Result: Total of 280 patients were enrolled for the study. 33patients were excluded. We found Naftopidil and combinationto be significanty better for pain score, combination beingmore effective for storage symptoms, voiding symptoms andquality of life scores.Conclusion: Combination of Tolterodine and Naftopidil canbe recommended for relief of stent related discomfort andurinary symptoms.
ABSTRACT
Introduction: Decision making regarding the surgicalapproach for ACOM artery is based on A1 dominancy,projection and how is the plane of the both A2 vessels. Thepresent study was conducted with the aim to analyze theprognosis of superiorly projecting anterior communicatingartery aneurysm with respect to position of A2 anteriorcerebral artery.Material and methods: The present retrospective analysisconsisted of 543 cases of all cerebral aneurysms operatedfrom Jan 2012 to December 2015 at Sree Chitra TirunalInstitute for Medical Sciences and Technology (SCTIMST),Trivandrum. The open A2 plane was defined as when the A2of the pterional approach side was present more posteriorlythan the contralateral A2. All patients were evaluated throughGlasgow outcome scale at the time of discharge. All the dataobtained was arranged in a tabulated form and analyzed usingSPSS software.Results: The mean age of the subjects was 54.2 years.There were 63 males and 32 females. Among 95 patients,A1dominant was present in 83 patients and co-dominance waspresent in 12 cases. Out of 54 superiorly projecting aneurysms.Intraoperative rupture was present in the 18 patients (33.3%),Gyrus rectus aspiration was done in the 35 patients (64.9%), 1patient had the perforator injury.Conclusion: Surgical approach from the A2 posteriordisplacement side (the open A2 plane) in patients with superiorprojecting aneurysms allows neurosurgeon to secure aneurysmnecks safely and prevent postoperative complications.
ABSTRACT
Introduction: Urethral stricture is the term used for anteriorurethral disease, or spongiofibrosis. Current research aimed tostudy buccal mucosal graft and penile skin grafts for dorsalonlay urethroplasty.Material and methods: This was a prospective studyconducted at the department of Surgery, R.I.M.S., Ranchifrom November 2010 to October 2012 in urethral stricturecases in male adults. Detail history taking and imagingprocedures were done for all patients. Patients were dividedinto two groups. The first group underwent buccal mucosalgraft and the second group underwent penile skin graft.Result: A total of 43 patients were included in the study.We found that urethral stricture was most common in theage group of 31-40 years. On follow-up, one patient (5%) inthe BMG group and 3 patients (15%) in the PSG group hadthinning of stream/failure.Conclusion: For substitution urethroplasty, buccal mucosashould be the preferred substitute but penile skin can be usedin cases when the buccal mucosa is unavailable as in cases ofsub mucosal fibrosis.