Prospective Study of 500 Cases of TURP

Introduction: Clinical benign prostatic hyperplasia (BPH)is one of the most common cause of lower urinary tractsymptoms in ageing men. Gold standard for BPH now days,is transurethral resection of the prostate (TURP). Hence; thepresent study was planned to prospectively analyse 500 TURPcases.Material and methods: 500 patients who underwent TURPafter failed medical therapy for BPH or with absoluteindication for TURP were anlayzed. All patients underwentultrasonography for post void residual urine and prostatesize, Serum PSA, DRE and uroflowmetry. Urine routineand culture along with renal function test was done in allpatients. Urodynamic study was done in patients suspectedfor neurogenic bladder. Data in relation to intraoperativeparameters and postoperative follow-up were analysed.Results: In the present study, data of a total of 500 patientswas analysed. Fever, haematuria and clot retention was foundto be present in 20, 25 and 18 patients respectively. Deathoccurred in 1 patient due to cardiac complication. Bloodtransfusion was required in 50 patients. Stricture and bladderneck contracture was seen in 16 and 9 patients respectively asa manifestation of late complication. Incontinence was foundto be present in 1 patients.Conclusion: TURP is one of the best minimally invasivetreatment for BPH. Along with being cost-effective, it isalso associated with significantly shorter hospital stay andminimum morbidity

Evaluation of enzymes in serum and cerebrospinal fluid in cases of stroke.

Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatine kinase (CK) were estimated in serum and cerebrospinal fluid of 25 patients of stroke, and were correlated with severity of disease. 21 (84%) patients had ischemic stroke and four (16%) had hemorrhagic stroke. Serum and CSF AST levels were significantly elevated in the study group. The rise in CSF AST was more in the hemorrhagic subtype than in the ischemic subtype. Serum ALT and CSF LDH levels were also significantly elevated in patients with ischemic stroke. None of the enzyme levels were related to the severity of disease as assessed by the Glasgow coma scale.

A study of prevalence of health problems in asymptomatic elderly individuals in Delhi.

A survey was conducted in asymptomatic aged individuals (> or = 60 years) in The National Capital Territory of Delhi for the prevalence of major health problems like hypertension, diabetes mellitus and respiratory diseases. A total of 200 individuals (100 males and 100 females) were studied over a period of three months in 1998-99. Hypertension was defined as BP > or = 140/90 mmHg (JNC VI criteria), while diabetes mellitus was diagnosed if fasting whole blood sugar was 120 mg/dl or more (WHO criteria). Diagnosis of other health problems was based on relevant history and physical examination. Prevalence of hypertension in the study group was 32.5 per cent (more in males). Of these 18 per cent and 4.2 per cent had isolated systolic and diastolic hypertension, respectively. Prevalence of diabetes mellitus in the same population was 13.0 per cent. Both diseases were more prevalent in urban population. A high prevalence of respiratory disorders was observed (pulmonary tuberculosis 16 per cent, COPD 10 per cent, asthma 4.5 per cent). Cataract was present in 7.5 per cent while 1.5 per cent had symptoms of urinary tract infection. History of Jaundice was present in 3.5 per cent. Three per cent each had a history suggestive of IHD and TIA, respectively. Proteinuria and glycosuria was seen in 22.2 and 7.6 percent, respectively. A large percentage of the study group (34.4 per cent) had asymptomatic ECG abnormalities.

Clinicohaematological profile in chronic renal failure.

OBJECTIVE: Aim of the study was to observe the clinicohaematological profile, bone marrow and serum iron indices of patients with chronic renal failure. METHOD: A total of 27 patients of chronic renal failure were selected, irrespective of their age, sex, clinical profile and etiology. These patients were not on dialysis, haematinics or erythropoietin therapy. They underwent series of biochemical and haematological investigation including bone marrow aspiration and also estimation of serum iron indices. RESULTS: The commonest cause of chronic renal failure in study group was diabetes mellitus (20%), glomerulonephritis (8%). Fifty percent of the patients on first presentation were in end-stage renal disease. Most patients presented with features of anaemia (94%), uraemia (63%) and fluid overload (96%). Severity of anaemia was correlating with degree of azotemia. Sixty percent of the patients had microcytic hypochromic anaemia, five percent had macrocytic anaemia while 30% had normocytic normochromic anaemia. The reticulocyte count was high in 46% of the patients. RDW-CV of greater than 14 was observed in 67%. Thrombocytopaenia was found in 52% of the patients. Leucocyte count was within normal range in 75%. In differential leucocyte count and absolute eosinophil count was high in 32% of the subject. In bone marrow examination 61% of the patients had normal bone marrow cellularity, 75% were having erythroid hyperplasia. Fifty seven percent of the cases had bone marrow iron store of zero, 37.8% had normal bone marrow iron store, 6.5% had increased bone marrow iron store. Serum ferritin was low in 62% and serum iron was below normal in 74% of the patients. CONCLUSION: Majority (65%) of patient had microcytic hypochronic anaemia because of iron deficiency and 33% of patient had parasitic infestation.

Hyperfibrinogenemia in patients of diabetes mellitus in relation to glycemic control and urinary albumin excretion rate.

BACKGROUND: Diabetics have higher cardiovascular morbidity and mortality than general population and hyperfibrinogenemia is one of the important risk factors. MATERIAL AND METHODS: In the present study fibrinogen levels (dry clot weight method) were estimated in 50 diabetic subjects and 10 age, sex and body mass index matched controls and its correlation with various parameters like glycosylated hemoglobin (cation exchange resin method), urinary albumin excretion rate (Esbach's albuminometer), age, hypertension, body mass index (Kg/m2), lipid profile, smoking, duration of diabetes was studied. RESULTS: Higher plasma fibrinogen levels were found in diabetics (7.30 +/- 5.87 g/l) as compared to controls (4.06 +/- 2.5 g/l) which was statistically significant (p = 0.022). Fibrinogen levels were associated with age (r = 0.873), hypertension (p = 0.032), body mass index (r = 0.898), triglyceride level (r = 0.9396), cholesterol level (r = 0.99), glycosylated hemoglobin (r = 0.99) and urine albumin excretion rate (r = 0.930) in diabetics, in a significant manner. But, no correlation was found with sex (p > 0.05), family history (p = 0.072), duration of diabetes (r = 0.443) and smoking (p = 0.081). In controls positive correlation was found between fibrinogen level and age (r = 0.5), family history (p = 0.04), smoking (p = 0.051), body mass index (r = 0.898) and lipid profile (r > 0.5). Mean albumin excretion rate was significantly (p = 0.002) higher in diabetics (397.42 +/- 956.51 mg/min) and it was found to be associated with age (r > 0.5) and lipid profile (r > 0.5) in both diabetics and controls. No correlation was found between glycemic control and urine albumin excretion rate. CONCLUSION: Diabetics have higher fibrinogen levels, which is associated with glycemic control and urine albumin excretion rate in a statistically significant manner.

Diagnostic utility of estimation of mycobacterial antigen A60 specific immunoglobulins in serum and CSF in adult neurotuberculosis.

An ELISA assay based on mycobacterial antigen A60 (Anda, Biologicals France) was used to detect specific immunoglobulins (IgM, IgA and IgG) in 48 cases of adult neurotuberculosis (24 TBM; 24 Tuberculoma) and in 48 controls (24 diseased controls; 24 healthy controls). Serum was analysed in all the subjects whereas CSF was assayed only in TBM cases and diseased controls. The cut off values used for IgM, IgG and IgA in this study were 1.500 ODI (optical density index) at 1:100 dil, 250 units/ml and 150units/ml respectively in serum; and 1.500 ODI at 1:10 dil, 10 units/ml and 10 units/ml respectively in CSF. The mean titres of all three antibodies were found to be significantly higher in cases as compared to controls. In cases of TBM, in serum, the percentage positivity for IgM, IgG, IgA and combination of IgG or IgA were 41.67, 87.50 87.50 and 95.83 respectively. The corresponding figures in CSF were 62.50, 75.0, 66.67 and 79.16 for IgM, IgG, IgA and 'IgA or IgM' respectively. In tuberculoma cases, in serum, the figures were 37.50, 75.0, 75.0 and 83.33 respectively. Overall, a high sensitivity and specificity were obtained in cases of TBM (Serum: ST = 95.83%: SP = 87.50%; CSF ST = 79.16%. SP = 100%) and Tuberculoma cases (serum: ST = 83.33% SP = 87.50%) employing the combined antibody estimations.

Effect of Sahaja yoga practice on seizure control & EEG changes in patients of epilepsy.

The effect of Sahaja yoga meditation on seizure control and electroencephalographic alterations was assessed in 32 patients of idiopathic epilepsy. The subjects were randomly divided into 3 groups. Group I (n = 10) practised Sahaja yoga for 6 months, Group II (n = 10) practised exercises mimicking Sahaja yoga for 6 months and Group III (n = 12) served as the epileptic control group. Group I subjects reported a 62 per cent decrease in seizure frequency at 3 months and a further decrease of 86 per cent at 6 months of intervention. Power spectral analysis of EEG showed a shift in frequency from 0-8 Hz towards 8-20 Hz. The ratios of EEG powers in delta (D), theta (T), alpha (A) and beta (B) bands i.e., A/D, A/D + T, A/T and A + B/D + T were increased. Per cent D power decreased and per cent A increased. No significant changes in any of the parameters were found in Groups II and III, indicating that Sahaja yoga practice brings about seizure reduction and EEG changes. Sahaja yoga could prove to be beneficial in the management of patients of epilepsy.

Brainstem auditory evoked potentials in epileptics on different anti-epileptic drugs.

The effects of anti-epileptic drugs (AEDs) on brainstem auditory evoked potentials (BAEPs) were studied on 32 female patients of epilepsy and 10 age-matched normal healthy females (NS). The patients were divided into 6 groups, those not receiving medication (drug free, DF) and those receiving AEDs: Phenytoin (PHT), Carbamazepine (CBZ), Phenobarbital (PB), a combination of PHT and PB and a combination of CBZ and PB. DF epileptics had shortened were V absolute latency (AL) and I-V interpeak latency (IPL) as compared to NS. Phenytoin and CBZ monotherapy produced a prolongation of wave III AL (by PHT only), wave V AL, wave I-III IPL and I-V IPL, as compared to DF epileptics. Phenytoin monotherapy also prolonged wave III AL and I-III IPL, as compared to NS. When PB in the dosage of 30-60 mg/d was used in combination with PHT the above mentioned changes were not observed. These findings indicate altered neuronal conduction and/or synaptic transmission in epileptics. Anti-epileptic drugs in the dosages studied, with exception of PHT appear to lead towards "normalization" of BAEPs.

Coxsackie B virus in the etiology of heart diseases in Delhi.

Coxsackie B group of viruses have been long considered as the precipitating factor in heart diseases. Their association with various heart diseases especially pericarditis, myocarditis and myopericarditis is known, but now their association is also known with cardiomyopathy and ischaemic heart diseases. A study was carried out on 87 patients suffering from various heart diseases and the role of Coxackie B virus infection was studied. The study included 25 control subjects. Thirty patients (34.5%) were found to be having high antibody titre for at least one of coxsackie B virus group with coxsackie B3 and B4 being the two commonest types. Serum IgM immunoglobulins were raised in acute infective disorders like pericarditis, myocarditis and myopericarditis but IgG, IgA and IgM levels were normal in ischaemic heart diseases and cardiomyopathy.

Effect of Sahaja yoga practice on stress management in patients of epilepsy.

An attempt was made to evaluate the effect of Sahaja yoga meditation in stress management in patients of epilepsy. The study was carried out on 32 patients of epilepsy who were rendomly divided into 3 groups: group I subjects practised Sahaja yoga meditation for 6 months, group II subjects practised postural exercises mimicking Sahaja yoga and group III served as the epileptic control group. Galvanic skin resistance (GSR), blood lactate and urinary vinyl mandelic acid (U-VMA) were recorded at 0, 3 and 6 months. There were significant changes at 3 & 6 months as compared to 0 month values in GSR, blood lactate and U-VMA levels in group I subjects, but not in group II and group III subjects. The results indicate that reduction in stress following Sahaja yoga practice may be responsible for clinical improvement which had been earlier reported in patients who practised Sahaja yoga.

Incidence of coxsackie (B) virus infection in diabetics.

45 diabetic patients were screened for raised titres against Coxsackie group of viruses. 11 diabetic patients showed raised titres of neutralising antibodies against one of the coxsackie group of viruses, as against 3 in 25 controls.

Immunoglobulins in viral hepatitis.

Serum immunoglobulin G, M and A levels were studied in 4 patients of type A, 23 patients of type B and 23 cases of non A-non B hepatitis. Sixteen age and sex matched healthy individuals were stydied as controls. IgM levels were found to be significantly raised in all the 3 types of hepatitis patients as compared to those in controls, while IgG and IgA levels were not significantly altered in any type of hepatitis. There was no statistically significant difference between the increased levels of IgM in various types of hepatitis. No immunoglobulin response was found to be characteristic of any particular type of hepatitis.

Pulmonary complications of septicaemia in women.

Twenty-five female patients of septicaemia aged 15-50 years comprised this study. Twenty-three patients (92%) were in the reproductive age group (15-35 years). Sixteen patients (64%) had some relation to parity, suggesting an increased risk of septicaemia in women with puerperal sepsis. The commonest primary source of infection was the female genital tract (48%). Gram-negative septicaemia was the commonest. The pleuropulmonary complications observed were pneumonia (10 cases), lung abscess (7 cases), empyema (3 cases), septic pulmonary embolisation (4 cases) and adult respiratory distress syndrome (4 cases). Seven cases of the total 25 died. Adult respiratory distress syndrome with septicaemia was the commonest cause of mortality in these patients.