Spontaneous Trans-Abdominal Expulsion of a Foreign Body: A Rare Occurrence.

Large and sharp foreign bodies invariably need surgical removal. A 55-year-old male, had epigastric pain, two weeks after accidental ingestion of wooden tooth brush. Later he developed pain, fever and indurations in left iliac fossa followed by spontaneous expulsion of foreign body through indurated area on the anterior abdominal wall. Contrast enhanced computed tomography revealed an inflammatory tract along the posterior wall of stomach communicating with the anterior abdominal wall. Patient was managed conservatively and made an uneventful recovery.

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial.

UNLABELLED: The aim of the study was to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire. MATERIAL AND METHODS: Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student's unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant. RESULTS: Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value - 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value - 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects. CONCLUSIONS: Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

Rare adrenal gland emergencies: a case series of giant myelolipoma presenting with massive hemorrhage and abscess.

INTRODUCTION: Adrenal Myelolipoma is a rare benign neoplasm, which contains mature adipose tissue and variable amounts of haematopoietic elements. Most lesions are small and asymptomatic, discovered incidentally during autopsy or imaging studies performed for other reasons. CASE PRESENTATION: Here we reported a series of two cases of giant myelolipomas of the adrenal gland; first one the largest tumor reported so far presented with massive hemorrhage and the second case introduced with its rare unreported presentation of adrenal myelolipomas i.e. a large abscess. DISCUSSION: Adrenal myelolipoma is a rare and asymptomatic tumor usually discovered incidentally in less than 1% of population on autopsy or imaging performed for other reasons. There is an increasing incidence of large adrenal myelolipoma (> 10 cm) presenting with life threatening and recurrent retroperitoneal hemorrhage along with other complications as abscess. To avoid such a life-threatening situation, authors recommend close monitoring and consideration of urgent surgical intervention for tumors larger than 4 cm at presentation or increase in size or change in appearance during follow-up.