RESUMO
Enlargement of prostate can be benign and malignant. Though differentiation between the two can be made on clinical grounds and surgery but still some cases can be missed if not subjected to histopathology. To find out the frequency of malignancy in patients operated for clinically benign open transvesical prostatectomy. Study type settings and duration: It was a prospective observational study conducted in the Department of surgery [Surgical Unit-I], Ghulam Muhammad Mahar Medical College and Hospital, Sukkur from January 2011 to December 2011. Patients presented with the history of prostatic symptoms were evaluated in surgical out-patient's department using digital rectal examination and ultrasound. The findings were recorded in a proforma and those having enlarged prostate weighing above 40gm underwent prostate specific antigen testing. Patients having no malignant findings on history, digital rectal examination and whose prostate specific antigen levels were below 10 ng/dl underwent open transvesical prostatectomy and all specimens were sent for histopathology. Those with suspicion of malignancy either on history or digital rectal examination or high prostate specific antigen were excluded from the study, also the glands below 40 gm in volume were excluded and referred for transurethral resection. All specimens were sent for hisopathology. Out of 100 cases, 41 were between 56 to 65 years of age. The mean age was 58 years. Acute urinary retention requiring catheterization was seen in 36 cases while 18 patients had symptoms suggestive of inguinal hernia but on examination had enlarged prostate. Prostate specific antigen was done in 07 patients with suspicion of malignancy but its value was below 10 ng/dl therefore they were included in the study. On ultrasound the gland volume ranged from 40 to 85 gm and residual post-voidal urinary volume ranged from 100 to 450ml. On histology 06 patients were found to have adenocarcinoma of prostate including 01 patient in whom mucosa of the gland was fixed but as the prostate specific antigen was below 10 ng/dl so the patient was kept in study group. Gleason score ranged from 4 to 9. Direct rectal examination is not a reliable test to detect early malignant changes in prostate and all specimens should be subjected to histopathology. Policy message: Histopathology of all operated and biopsied materials should be done to complete diagnosis
RESUMO
To determine the effectiveness of ablative partial nail excision with phenolization in advanced stage onychocryptosis [ingrown toe nail]. Study type, settings and duration: An interventional study carried out at Department of Surgery, Ghulam Muhammad Mahar Medical College, Teaching Hospital, Sukkur from January 2009 to December 2009. Patients coming to the surgical department with advanced stage [stage-II and III] or recurrence of ingrown toe nail were included in the study. Patients with stage-I disease, diabetics, with trauma and vascular causes were excluded. All patients were operated as day cases with partial nail excision and chemical ablation with phenol. Results: A total of 56 patients underwent the procedure. There were 44[78.5%] males and 12[21.4%] females. Forty six patients were operated for the first time while 8[14.2%] patients were recurrent cases who were operated previously elsewhere. Post operatively and after chemical ablation, 41[73.2%] patients showed improvement with quite good pain relief and reduced swelling on third day, 15[26.7%] patients improved in two weeks. At 2 months 22[39.2%] patients were lost to follow up. Recurrence was observed only in 7[12.5%] patients after four and a half months. Delayed wound healing for upto three weeks was noticed in 3[5.3%] patients while moderate to severe pain requiring strong analgesics for one month was seen in 6[10.7%] patients. Majority of patients n=36 [64.2%] became symptoms free in 10 days. Partial nail excision with phenolization is a simple and effective procedure with low recurrence rates for patients with advanced ingrown toe nail