ABSTRACT
Background: Benign prostatic hyperplasia (BPH) is the most common urological condition. The treatment of BPH depends on the severity of symptoms which aims to improve symptoms, lower the risk of progression and improve quality of life. The aim of this survey was to understand the prescription pattern of alpha blockers in the treatment of BPH among clinicians of India.Methods: A cross-sectional questionnaire-based survey was conducted between September to December 2018. Data regarding the management of BPH using ?-blockers were filled by clinicians and collated for data analysis using appropriate statistical test.Results: Total of 1764 clinicians’ responses was collected and the result was analysed. According to the survey, 47.68% of clinicians felt that severity of the BPH symptoms is most common deciding factor for medical management of BPH. For the pharmacological management of BPH patients, around 58% of clinicians opted for ? blockers monotherapy as a preferred option. Among ? blockers, 65.14% of clinicians preferred tamsulosin as first line therapy for management of BPH patients. In this survey, 81.75% of clinicians believed that tamsulosin offers highest persistence rate among commonly prescribed ? blockers. Looking at the switching to a second ?-blocker, 75.45% of clinicians felt that tamsulosin shows the highest return rate following initiation of a second ?-blocker. More than 90% of clinicians felt that favourable efficacy or tolerability of tamsulosin is due to its highest persistence and highest return rates.Conclusions: Tamsulosin is the most commonly preferred and prescribed ?-blocker by Indian clinicians due to its favourable efficacy or tolerability.
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: 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.