Monitoring and Evaluation of Thyroid Function Tests, Serum Electrolytes and Creatinine Levels Before and After 131I Therapy.

BACKGROUND: Serum electrolytes, Creatinine, and thyroid profile play an important role in 131I treated patients of thyroid disorders. OBJECTIVES: To determine the effect of radioactive iodine (131I) on renal parameters, serum electrolytes and the correlation among TFT'S, creatinine, and chloride levels before and after I131 treatment in thyroid disorders. METHODS: The study was performed on 55 patients of thyrotoxicosis with age ranging from 16-65 years (mean age= 41±14years and BMI=24.8±4.46). The significance of the differences between the results of 1st, 2nd, and 3rd-time serum analysis was assessed by paired Student's t-test. Association between parameters was assessed by Spearman correlation analysis. RESULTS: 40 patients were taking Carbimazole, and 15 were directly recommended for I131 therapy. Strongly significant variations were observed for TFT'S (T3=0.012, T4 =0.017, and TSH=0. 001) during the follow-up treatment. Before taking I131 (Serum analyzed at 1st time), there observed negative correlation of T3(r=-.46, p=0. 002) and TSH (r=-0.31, p=0.02) with creatinine, and positive correlation of TSH(r=0.29,p=0.02) with chloride. BMI was negatively correlated with potassium(r=-0.30, p=0.02). At the 2nd time (after stopping the Carbimazole), no correlation results were observed. Two months after oral administration of 131I, creatinine, and chloride level was significantly increased (p=0.000), (P=0. 03) respectively, but had no correlation with TFT'S. CONCLUSION: Our findings suggest that patients with goiter (diffused or toxic) have association of TFT'S and BMI with serum electrolytes and creatinine, 131I therapy is also associated with the increase in creatinine and chloride levels of patients leading to kidney problems.

Patient experience and satisfaction with Onabotulinumtoxin A for refractory overactive bladder.

OBJECTIVE: To evaluate the patient experience of our dedicated botulinum toxin A (BTX-A) service using a validated patient-reported experience measure (PREM) and assess patient-reported satisfaction with treatment. MATERIALS AND METHODS: The first 100 patients who underwent BTX-A treatment for refractory idiopathic detrusor overactivity (IDO) in our institution were contacted for telephone interview. They had all been assessed, injected and followed up in a dedicated BTX-A clinic. Patients were asked to complete a validated PREM - the Client Satisfaction Questionnaire (CSQ-8) - as well as a questionnaire developed in our department to assess satisfaction with the results of the treatment. Most patients received 200 U OnabotulinumtoxinA (Botox(®) ) via an outpatient local anaesthetic flexible cystoscopy technique. RESULTS: Complete data was available for 72 patients. In all, 49 patients were continuing to receive BTX-A treatment while 23 had opted for no further injections. The overall mean (sd) CSQ-8 satisfaction score was 38.3 (3.3), indicating a high level of patient satisfaction with the service offered in our institution. There was a significant difference in total satisfaction scores between those still receiving BTX-A (mean score 29.8) and those who have discontinued treatment (mean score 25.1) (P < 0.01). Overall patient satisfaction with the result of the treatment was high with an overall mean (sd) score of 8.6 (2.0) on a visual analogue scale. Of those who had discontinued BTX-A, most were either using conservative measures only (44%) or had recommenced anticholinergic medications. CONCLUSION: Overall patient satisfaction with the dedicated BTX-A service offered in our institution is high and can result in a positive patient experience. The use of PREMs are advocated in order to fully capture the patient's views of the quality of services and treatments they receive.

Face, content, and construct validation of the Bristol TURP trainer.

INTRODUCTION: Validation studies are an important part of simulator evaluation and are considered necessary to establish the effectiveness of simulation-based training. The widely used Bristol transurethral resection of prostate (TURP) simulator has not been formally validated. OBJECTIVES: Evaluation of the face, content, and construct validities of the Bristol TURP simulator as an endourology training tool. DESIGN: Using established validation methodology, face, content, and construct validities were evaluated. Face and content validities were assessed using a structured quantitative survey. Construct validity was assessed by comparing the performance of experts and novices using a validated performance scale and resection efficiency. PARTICIPANTS AND SETTING: Overall, 8 novice urologists and 8 expert urologists participated in the study. The study was conducted in a dedicated surgical simulation training facility. RESULTS: All 16 participants felt the model was a good training tool and should be used as an essential part of urology training (face validity). Content validity evaluation showed that most aspects of the simulator were adequately realistic (mean Likert scores 3.38-3.57/5); however, the model does not simulate bleeding. Experts significantly outperformed novices (p < 0.001) across all measures of performance, therefore establishing construct validity. CONCLUSIONS: The Bristol TURP simulator shows face, content, and construct validities, although some aspects of the simulator were not very realistic (e.g., bleeding). This study provides evidence for the continuing use of this simulator in endourology training.