Comparison of the urinary flow rate improvement after transurethral incision and transurethral resection of prostate for small sized symptomatic benign enlargement

Objective: To compare the mean improvement in urinary flow rate after transurethral resection of prostate [TURP] and transurethral incision of prostate [TUIP] for small sized symptomatic benign prostatic enlargement [SBE]

Study design: Randomized controlled trial

Duration of study: January 2016 to December 2017

Setting: Department of Urology Institute of Kidney Diseases Hayatabad Peshawar

Methodology: A total of 216 patients presenting to our OPD having lower urinary tract symptoms due to benign prostatic enlargement were included in the study. Their medical history, physical and digital rectal examination were performed. Urine analysis, urine C/S, Blood Complete, Serum Creatinine Prostate Specific Antigen, Uroflowmetry and Ultrasound were performed. All patients were randomized into two groups; Group A [TURP] and Grouped B [TUIP]

Results: Our study shows that in Group A [TURP] mean age was 57 years with standard deviation +/- 3.78 while in Group B [TUIP] mean age was 60 years with standard deviation +/- 3.13. The status of uroflowmetry[post-operative] among two groups was analyzed as in Group A [TURP] 5[5 percent] patients had uroflowmetry<15 ml while 103[95 percent] patients had uroflowmetry>15 ml. Mean uroflowmetry was 17 ml with standard deviation +/- 3.64. Where as in Group B [TUIP] 9[8 percent] patients had uroflowmetry<15 ml while 99[92 percent] patients had uroflowmetry>15 ml. Mean uroflowmetry was 16 ml with standard deviation +/- 3.55. Mean urinary flow rate was compared between TURP and TUIP in which showed that there is no significant difference between the two surgical procedures in term of urinary flow rate

Conclusion: Our study concludes that there was no significant difference between TURP and TUIP in term of mean urinary flow rate for small sized symptomatic benign prostatic enlargement

Presence of multiple antimicrobial resistant strains and frequency of pseudomonas aeruginosa in bronchiectasis patients in balochistan

Objective: To discover the frequency and presence of multiple antimicrobial resistant strains of Pseudomonas aeruginosa [P.aeruginosa] in patients with Post tuberculosis bronchiectasis in Baluchistan

Design: A prospective descriptive study

Place and duration: this study was done in Pulmonology and tuberculosis outpatient department [OPD] of Fatimah Jinnah Chest Hospital and Rehan Hospital Quetta Pakistan from 1st October 2011 to 1st April 2012

Methodology: The samples were obtained from post tuberculosis patients [n=60, Age = 40+ years] suspected of bronchiectasis who were subjected to spirometry test, Mueller Hinton sensitivity testing, oxidase test and disk-diffusion method to find out frequency and multiple drug resistance of P. aeruginosa

Results: Our results confirmed the association of chronic P. aeruginosa infection with poor lung function. It is not clear whether P. aeruginosa caused the accelerated decline in lung function or it was just a marker of those whose lung function was already declining rapidly. The antibiotic susceptibility testing confirmed the presence of resistant strains of the P. aeruginosa most of which were mucoid strains. It proved that a single antibiotic therapy is not a good treatment for patients with P. aeruginosa infection in airways

Conclusion: Bronchiectasis is more frequently encountered in middle-aged and elderly persons and resistant strains of P. aeruginosa are highly prevalent in these patients

Clinical features and early diagnosis of typhoid fever emphasizing usefulness of detecting mesenteric lymphadenopathy with ultrasound as diagnostic method.

Typhoid fever is endemic in Pakistan. Most patients are children. As the symptoms and signs are often unspecific, it is difficult to diagnose typhoid fever without blood culture. We retrospectively reviewed 51 cases of typhoid fever who were all admitted from 1 June through 31 August 2002. Sixteen cases were positive by blood culture and confirmed as typhoid fever. All cases had Salmonella typhi. Although 16 cases were culture-negative, they were clinically diagnosed as typhoid fever. The remaining 19 cases were clinically diagnosed without blood culture. The clinical features of the culture-confirmed cases were more severe than the culture-negative cases. Mesenteric lymphadenopathy was very frequently detected with ultrasonography, in both culture-confirmed and culture-negative cases. The rates of detecting mesenteric lymphadenopathy were 69% and 63%, respectively. Meanwhile, the rate in non-typhoid fever patients was 5.5%. It was considered that detecting mesenteric lymphadenopathy with ultrasonography was very useful in the diagosis of typhoid fever in endemic areas.