ABSTRACT
Background: Sexual desire and sexual activity are natural needs of human beings, which can be problematic and lead to various sexual disorders, if not used in the right way, including hypersexuality. The present study aimed to compare the effect of dialectical behavior therapy (DBT) and aripiprazole drug on marital instability in patients with hypersexuality. Materials and Methods: This experimental case--control Pretest--Posttest Control Group Design with follow up was done on 27 male and female patients with hypersexuality having at least a higher education degree selected from four hospitals and psychiatric centers including Khorshid Hospital, Asgariyeh Specialized Hospital, Farhangian Clinic and Imam Reza Medical Center in Isfahan and were randomly assigned to two groups of treatment (nine patients in every group) and one group of control (nine patients) after adjusting the age and gender. Pretest phase was done for both three groups using Marital Instability Index (MII). The first treatment group underwent DBT intervention for eight sessions of 2 hours (once a week), and the second experimental group was prescribed aripiprazole for 2 months. Afterwards, the posttest and follow-up were performed for all the three groups. The data were analyzed using SPSS 24 and multivariate analysis of covariance (MANCOVA). Results: The findings showed that DBT and aripiprazole had little effect on the problem of marital instability in patients with hypersexuality (p > 0.05); also, there was no significant difference between the effect of DBT and aripiprazole (p > 0.05). Conclusion: DBT and the drug aripiprazole cannot have a significant effect on the marital instability in patients.
ABSTRACT
Background: Delayed bleeding after percutaneous nephrolithotomy (PCNL), which may occur within the first 3 weeks postoperatively, is a life-threatening complication that may result from arteriovenous fistula and arterial pseudoaneurysm. Angioembolization is the standard treatment when these patients develop hemodynamic instability despite conservative measures. Contrast hypersensitivity and renal insufficiency, however, contraindicate angiogram and subsequent embolization; in these patients, alternative methods such as the one described in this study may help in resolving the renal hemorrhage. Case Presentation: In this case series, we report the effective management of post-PCNL hemorrhage with nephroscopy and nephrostomy and drainage and tamponade because angioembolization was not feasible. Conclusion: Delayed bleeding after PCNL may be managed conservatively with nephrostomy drainage and tamponade when angioembolization is not feasible.
ABSTRACT
BACKGROUND: To evaluate the efficacy of fibrin glue injection in the prostatic fossa at the end of transurethral resection of prostate (TURP), in decreasing postoperative bleeding in patient with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: In this prospective randomized clinical trial, sixty patients with BPH, who were a candidate for TURP, were randomly divided into two equal groups. In the intervention group, 10cc of fibrin glue was injected in the prostatic fossa at the end of the surgery; through a 5 Fr feeding tube attached to Foley catheter and its tip was proximal to the balloon of catheter. The other thirty patients created the control group. Hemoglobin (Hb) level and lower urinary tract symptoms (LUTS) score were recorded before and 6, 24, 48 h, and 5 days after TURP. RESULTS: The mean age of the patients and prostate volumes were comparable between the groups. The mean Hb level before and 6 h after TURP were not different between the two groups, however, 24 and 48 h and 5 days after TURP, there was a significant difference as well as a higher decrease in the mean Hb level of the control group (P = 0.023). The mean LUTS score was not statistically different between the two groups. CONCLUSION: Fibrin glue injection in the prostatic after TURP reduces postoperative bleeding without any effect on LUTS score in patients with BPH.
