The correlation between obesity and prostate volume in patients with benign prostatic hyperplasia: A prospective cohort study.

OBJECTIVE/BACKGROUND: Benign prostatic hyperplasia (BPH) is increasing substantial burden on health care systems. Men with high body mass index (BMI) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH. METHOD: The study included 560 patients (50-80 years) with BPH. Weight and height measured to calculate BMI. TRUS was used to measure PV. Patient demographics such as IPSS score and prostate specific antigen (PSA) were also noted. RESULTS: Patients in the study had a mean age of 65.3 ± 9.45 years and the mean BMI was 23.97 ± 4.89 kg/m2. The mean PV of each BMI group were 37.45 ± 0.81, 57.89 ± 1.52 and 77.94 ± 2.17 (ml) for normal, overweight and obese groups, respectively, and the average PV score was 57.76 ± 1.50 ml. The mean PSA score was 3.26 ± 0.94 (ng/dl) with a range of 0.6-10.4. There was significant correlation between BMI and PV (p = 0.001) as well as between BMI with PSA and IPSS (p = 0.02, 0.001, respectively). CONCLUSION: The results showing strong correlation between BMI and PV also BMI with PSA and IPSS. Therefore reducing weight may lead to a lower prostate volume in the elderly stage, making LUTS less noticeable and improving quality of life.

Prevalence of LUTS in young female population attending tertiary care centre.

OBJECTIVE: To obtain the prevalence of lower urinary tract symptoms (LUTS) in young female population in tertiary care centre. METHOD: We conducted a descriptive and analytic study with ques tionnaire based data collection. All subjects were interviewed using conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS form in the urology outpatient department, SMS medical college and hospital, Jaipur (India). RESULT: Total 1278 patients enrolled in study. Using the well-structured questionnaire using ICIQ-FLUTS form, the prevalence of LUTS was 78.01% while conventional method having only 35.8%. This result revealed that LUTS is a common condition among young Indian female population with vaginal delivery as the common risk factor. CONCLUSION: Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS form is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice.

The effect of no oral antibiotic versus 7 days oral antibiotic during discharge in double J stented patients on stent related urinary tract infection: A randomized study.

OBJECTIVE: To evaluate effects of 7 days oral antibiotic prophylaxis versus no antibiotics in the patients with DJ stents after 3 days iv antibiotic on discharge with respect to urinary tract infection and stent related symptoms. MATERIAL AND METHODS: A prospective randomized study in 90 patients being stented post PCNL/URSL. Group A: no oral antibiotics was given at the time of discharge, Group B: 7 days of oral antibiotic was given at the time of discharge. Patients were followed up and outcomes were assessed in the form of lower urinary symptoms (LUTS), urine culture and sensitivity at 1 and 3 weeks and DJ stent culture and sensitivity on removal at 3 weeks. RESULTS: There was no significant difference in age, gender, type of surgery (PCNL/URSL), duration of DJ stent between the two groups. Patients in group A and Group B have comparable UTI and stent related symptoms at 1 and 3 weeks respectively (p = 0.95 and p = 0.916 respectively). Similarly, there were no marked difference in urine culture at 1 and 3 weeks, respectively between two groups (p = 0.71 and p = 0.63, respectively). Overall there were no significant differences in Urinary symptoms, urine culture/sensitivity at 1 and 3 weeks and also DJ stent culture and sensitivity on removal at 3 weeks between the two groups. CONCLUSION: The incidence of UTI and stent related symptoms are same in both the groups. Therefore, prescribing oral antibiotics on discharge in selected patient with DJ stent has no added benefit and should be avoided.

Comparison of perineal urethrostomy versus augmentation urethroplasty in anterior urethral stricture disease.

PURPOSE: Perineal urethrostomy and urethroplasty are very good options for complex and long anterior urethral strictures. A perineal urethroplasty is usually a neglected option. To our knowledge, a comparative study between augmentation urethroplasty and perineal urethrostomy has been not conducted regarding subjective and patient reported outcome measures. We compared both these groups in a high volume tertiary care hospital. MATERIALS AND METHODS: A prospective comparative study of augmentation urethroplasty and perineal urethroplasty for long anterior urethral stricture. it was defined by strictures of more than 3 cm. We compared demographic data, urinary and sexual function; and quality of life using validated PROMs (patient-reported outcome measures) between both above groups. RESULTS: Both groups had 40 patients each. IPSS score improvement for PU and AUP were 20 and 19.6, respectively(p = 0.1223); IIEF-5 score improvement for PU and AUP at baseline and after 6 months were 14.3 and 16.7, respectively(p = 0.1433); QOL score improvement for PU and AUP were 3.45 and 3.05, respectively; which was statistically significant (p ⩽ 0.001). CONCLUSIONS: Perineal urethrostomy is a good but neglected option for complex and long anterior urethral strictures and it should be considered one of the reliable treatment option for patients with long-segment urethral strictures.

The dissolution and solid-state behaviours of coground ibuprofen-glucosamine HCl.

The cogrinding technique is one of most effective methods for improving the dissolution of poorly water-soluble drugs and it is superior to other approaches from an economical as well as an environmental standpoint, as the technique does not require any toxic organic solvents. Present work explores the role of d-glucosamine HCl (GL) as a potential excipient to improve dissolution of a low melting point drug, ibuprofen (Ibu), using physical mixtures and coground formulations. The dissolution of the poorly soluble drug has been improved by changing the ratio of Ibu:GL and also grinding time. The results also showed that although GL can enhance the solubility of Ibu, it also reduces pH around the Ibu particles which led to poor dissolution performance when the concentration of GL is high. The effect of GL on the solubility of Ibu could be misleading if the pH of the final solution was not measured. Grinding reduced the particle size of GL significantly but in case of Ibu it was less effective. Solid state analysis (XRPD, DSC, and FT-IR) showed that ibuprofen is stable under grinding conditions, but the presence of high concentration of GL in samples subjected to high grinding times caused changes in FT-IR spectrum of Ibu which could be due to intermolecular hydrogen bond or esterification between the carboxylic acid group in the ibuprofen and hydroxyl group in the GL.

Enhancement of dissolution of nystatin from buccoadhesive tablets containing various surfactants and a solid dispersion formulation.

Nystatin is commonly employed to treat fungal infections in the mouth. It is not absorbed via the stomach and it will therefore not treat fungal infections in any part of the body other than the mouth. Nystatin buccoadhesive tablets release the drug very slowly due to the poor solubility of nystatin in water and also the presence of polymers with mucoadhesive properties. Therefore, the aim of the present study was to improve drug release from buccoadhesive tablets, while retaining adequate mucoadhesive properties. To this end, a solid dispersion of nystatin: lactose (1:3) was prepared and mixed with xanthan. The effects of hydrophilic surfactants such as cremophor RH40 and Tween 80 on drug release and mucoadhesive properties of nystatin tablets were also investigated as were swelling and erosion indices and strength of bioadhesion in vitro to a biological membrane. The interaction between nystatin and lactose in solid dispersion formulation was investigated by XRPD, FT-IR and DSC. The results showed that a solid dispersion formulation and mucoadhesive tablets containing surfactants led to faster drug release than their simple physical mixtures. Drug release was also faster from a solid dispersion compared to tablets containing surfactants. Swelling and erosion results showed that tablets made of a solid dispersion swelled and eroded faster than a physical mixture formulation. The presence of surfactant slightly increased the degree of swelling and erosion of buccoadhesive tablets.

Liquisolid compacts: the effect of cosolvent and HPMC on theophylline release.

Liquisolid technique as an approach was developed to sustain the drug release from matrix compacts. Liquisolid tablets were prepared by mixing liquid medication with silica-Eudragit RL or RS followed by the compaction of the mixture. For comparison purposes physical mixtures of all ingredients were prepared. The effect of the type of liquid medication and HPMC concentration on drug release was investigated. The interaction between excipients and theophylline was investigated by differential scanning calorimetry. Comparison study of physicomechnanical properties of liquisolid tablets with conventional tablets showed that most of liquisolid formulations had superior flowability and compactibility in comparison with physical mixtures. The results suggested that the presence of non-volatile cosolvent is vital to produce slow release pattern for some of liquisolid compacts. The type of cosolvent had significant effect on drug release and it was revealed that by changing the type of cosolvent the desirable release profile is achievable. The sustained release action of HPMC was enhanced in liquisolid compacts in comparison to simple sustained release matrix tablets. It was shown that liquisolid compacts has a potential to produce zero-order release kinetics for less water soluble drugs such as theophylline.

Principles and technique of using bonded post and cores.

This article discusses today's principles of adhesive dentistry and proposes new, conservative guidelines and techniques for post space preparation and post length for bonded post and cores. Also discussed is a technique using dual-cure composite resin and glass fiber posts to effectively perform a bonded post and core build-up procedure.