Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula

2009 ◽  
Vol 50 (3) ◽  
pp. 306-311 ◽  
Author(s):  
Chih-Wei Wang ◽  
Chun-Jung Juan ◽  
Yi-Jui Liu ◽  
Hsian-He Hsu ◽  
Hua-Shan Liu ◽  
...  
Keyword(s):  
Estimation Error ◽  
Positive Association ◽  
Volumetric Analysis ◽  
Intracerebral Hematoma ◽  
Computer Assisted ◽  
Hematoma Volume ◽  
Computed Tomography Scans ◽  
Group 3 ◽  
The Mean ◽  
Group 2

Background: Although the ABC/2 formula has been widely used to estimate the volume of intracerebral hematoma (ICH), the formula tends to overestimate hematoma volume. The volume-related imprecision of the ABC/2 formula has not been documented quantitatively. Purpose: To investigate the volume-dependent overestimation of the ABC/2 formula by comparing it with computer-assisted volumetric analysis (CAVA). Material and Methods: Forty patients who had suffered spontaneous ICH and who had undergone non-enhanced brain computed tomography scans were enrolled in this study. The ICH volume was estimated based on the ABC/2 formula and also calculated by CAVA. Based on the ICH volume calculated by the CAVA method, the patients were divided into three groups: group 1 consisted of 17 patients with an ICH volume of less than 20 ml; group 2 comprised 13 patients with an ICH volume of 20 to 40 ml; and group 3 was composed of 10 patients with an ICH volume larger than 40 ml. Results: The mean estimated hematoma volume was 43.6 ml when using the ABC/2 formula, compared with 33.8 ml when using the CAVA method. The mean estimated difference was 1.3 ml, 4.4 ml, and 31.4 ml for groups 1, 2, and 3, respectively, corresponding to an estimation error of 9.9%, 16.7%, and 37.1% by the ABC/2 formula ( P<0.05). Conclusion: The ABC/2 formula significantly overestimates the volume of ICH. A positive association between the estimation error and the volume of ICH is demonstrated.

scholarly journals Comparison of Common Methods for Precision Volume Measurement of Hematoma

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Minhong Chen ◽  
Zhong Li ◽  
Jianping Ding ◽  
Xingqi Lu ◽  
Yinan Cheng ◽  
...  
Keyword(s):  
Estimation Error ◽  
Volume Measurement ◽  
Normal Direction ◽  
Hematoma Volume ◽  
3D Slicer ◽  
Mean Estimation ◽  
Volumetric Models ◽  
The Mean ◽  
Group 2 ◽  
Slice Method

Purpose. Our aim is to conduct analysis and comparison of some methods commonly used to measure the volume of hematoma, for example, slice method, voxelization method, and 3D-Slicer software method (projection method). Method. In order to validate the accuracy of the slice method, voxelization method, and 3D-Slicer method, these three methods were first applied to measure two known volumetric models, respectively. Then, a total of 198 patients diagnosed with spontaneous intracerebral hemorrhage (ICH) were recruited. The patients were split into 3 different groups based on the hematoma size: group 1: volume<10 ml (n=89), group 2: volume between 10 and 20 ml (n=59), and group 3: volume>20 ml (n=50). And the shape of the hematoma was classed into regular (round to ellipsoid) with smooth margins (n=76), irregular with frayed margins (n=85), and multilobular (n=37). The slice method, voxelization method, and 3D-Slicer method were adopted to measure the volume of hematoma, respectively, considering the nonclosed models and the models which may contain inaccurate normal information during CT scan. Moreover, the results were compared with the 3D-Slicer method for closed models. Results. There was a significant estimation error (P<0.05) using these three methods to calculate the volume of the closed hematoma model. The estimated hematoma volume was calculated to be 14.2086743±0.900559087 ml, 14.2119130±0.900851812 ml, and 14.2123825±0.900835916 ml using slice method 1, slice method 2, and the voxelization method, respectively, compared to 14.212656±0.900992371 ml using the 3D-Slicer method. The mean estimation error was -0.00398172 ml, -0.00074303 ml, and -0.00027354 ml caused by slice method 1, slice method 2, and voxelization method, respectively. There was a significant estimation error (P<0.05), applying these three methods to calculate the volume of the nonclosed hematoma model. The estimated hematoma volume was calculated to be 14.1928246±0.902210314 ml using the 3D-Slicer method. The mean estimation error was calculated to be -0.00402121 ml, -0.00078237 ml, -0.00031288 ml, and -0.01983136 ml using slice method 1, slice method 2, voxelization method, and 3D-Slicer method, respectively. Conclusions. The 3D-Slicer software method is considered as a stable and capable method of high precision for the calculation of a closed hematoma model with correct normal direction, while it would be inappropriate for the nonclosed model nor the model with incorrect normal direction. The slice method and voxelization method can be the supplement and improvement of the 3D-Slicer software method, for the purpose of achieving precision medicine.

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

scholarly journals Correlation between Dermatoglyphics, Dental Caries and Salivary pH: An Invivo Study

1970 ◽  
Vol 29 (1) ◽  
Author(s):  
Tegginmani Veeresh ◽  
Ahmed Mujahid ◽  
Patil Deepu ◽  
Reddy Sivaprakash
Keyword(s):  
Genetic Disorders ◽  
Ridge Count ◽  
Chi Square ◽  
Salivary Ph ◽  
Loop Pattern ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Free People ◽  
And Control

BACKGROUND: Dermatoglyphic patterns that are often utilized in judicial and legal investigations are valuable in diagnosis of many diseases related to genetic disorders. Caries, being infectious in origin, might be related to genetics as well. Hence, these patterns are of significance in predicting caries development.MATERIALS AND METHODS: DMFT (decayed, missing, filled teeth) score of 300 female subjects within the age group 0f 18-25 years were recorded and accordingly divided into 3 groups of 100 each; group 1 (DMFT score=0), group 2 (DMFT score < 5) and group 3 (DMFT score ≥ 5). Dermatoglyphic patterns were recorded using Cummins and Midlo method. pH meter was used for recording salivary pH accurately. Fingerprint patterns and salivary pH recorded were correlated with DMFT scores of subject and control groups. Statistical analysis was performed using ANOVA and Chi-square tests (P < 0.05).RESULTS: The mean salivary pH was least in group 3. The predominant dermatoglyphic pattern observed in groups 1 and 2 was loop pattern whereas, in group 3, whorl pattern was predominant. The TFRC (total finger ridge count) was higher in group 3 compared to the other two groups.CONCLUSION: Caries-free people showed inflated frequency of loops, whereas subjects with high decay score had additional share of whorls. The TFRC was higher in individuals with high DMFT score, and salivary pH was inversely proportional to the DMFT score. 

scholarly journals In Vivo Therapeutic Effect of Triclabendazole + Levamisole on Hydatid Cyst in Rats

2020 ◽  
Vol 1 (1) ◽  
pp. 18-20
Author(s):  
Peyman Sadeghi ◽  
Yagoob Garedaghi ◽  
Mirhadi Khayatnouri ◽  
Hosein Hashemzade Farhang ◽  
Ramin Kaffash Elahi
Keyword(s):  
Hydatid Cyst ◽  
Close Contact ◽  
Control Group ◽  
Case Group ◽  
Hydatid Cysts ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
And Control

Introduction: Hydatidosis is a global disease and one of the most dangerous zoonotic diseases which is found in areas where humans, dogs, and herbivores are in close contact with each other. Methods: In this study, a total of 64 rats were divided into control and case groups, and then 3000 protoscolices were injected into the peritoneal cavity. After 2 months, rats in the case group were given triclabendazole + levamisole at a dose of 6 mg + 4.41 mg/mL orally for 60 days, respectively. Then, after 6 months of infection, the rats of the control and case groups were killed by anesthesia and then an autopsy was performed and the viscera were carefully examined for hydatid cyst infection. Results: The results showed that in the control group, 3 cysts were observed in the liver, 10 in the kidney, and 88 in the lung. The mean number of hydatid cysts in this group was determined to be 33.6. In the case group, 2 cysts were observed in the liver, 6 in the kidney, and 64 in the lungs. The mean number of hydatid cysts in the viscera was 24 in the case group. Conclusions: Statistical analysis of the results obtained from the case and control groups showed that the therapeutic efficacy of triclabendazole + levamisole was 31%, which is not enough to treat cases of hydatid cyst.

scholarly journals Evaluation of Iron Status, Haemoglobin and Protein Levels of Pregnant Women in Owerri Metropolis

2021 ◽  
pp. 36-43
Author(s):  
I. L. Okoroiwu ◽  
Jane Ugochi Chinedu-Madu ◽  
Emmanuel Ifeanyi Obeagu ◽  
C. C. N. Vincent ◽  
O. M. T. B. Ochiabuto ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Serum Iron ◽  
Iron Deficiency Anaemia ◽  
Iron Status ◽  
Second Trimester ◽  
Protein Levels ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

The study was done to determine iron status, haemoglobin and protein levels of pregnant women in owerri metropolis. A total of 100 pregnant women were recruited for this study. The mean Hb levels in group 1, group 2, and group 3· were 12.00±1.68g/dl, 10.06±1.J4g/dl and 10.96±1.19g/dl respectively. The mean Serum ferritin level of group 1 was 67.00±88.38ng/ml, group 2, 52.48±52.47ng/ml and group 3, 51.26±48.70ng/ml. The mean Serum iron in group 1, 2 and 3 were 46.72±16.41 g/dl, 79.59±63.24 g/dl and 83.35±53.04 g/dl respectively. In group 1, 2 and 3 the mean results. ( g/dl) of TIBC were 295.58 ± 109.53, 324.06 ± 178.00 and 319.88 ± 92.95 and % T.S (%) were 18.78 ± 11.77,26.59 ± 19.40 and 17.97 ± 10.87 percent respectively. The mean total protein was group 1,6.83±l1.77g/dl, group 2,6.39±0.70g/dl and group 3, 6.39 ±0.98 g/dl while the mean albumin (g/dl) in group 1, 2 and 3 were 4.84±0.47, 4.13±0.28 and 4.14±0.29 respectively. The mean values of globulin (g/dl) were 1.98 ± 0.91, 2.29 ± 0.87 and 1.89 ± 0.90 in groups 1, 2 and 3 respectively. As gestational age increased; serum ferritin, total protein, and albumin levels decreased while serum" iron and TIBC increased. The differences in the mean results between the groups were statistically significant (p<0.05) while % T.S and globulin levels when compared showed no significant difference (p>0.05). Iron status showed no statistical difference with increasing parity (p>0.05). However, from this study iron deficiency anaemia was most prevalent in second trimester; hence iron status estimation should be an integral part of routine antenatal care test during second trimester of each pregnancy for proper assessment and management of iron deficiency anaemia in pregnancy.

scholarly journals Serum Bioavailable Testosterone: Assayed or Calculated?

2006 ◽  
Vol 52 (3) ◽  
pp. 474-481 ◽  
Author(s):  
Frank Giton ◽  
Jean Fiet ◽  
Jérôme Guéchot ◽  
Fidaa Ibrahim ◽  
Françoise Bronsard ◽  
...  
Keyword(s):  
Ammonium Sulfate ◽  
Association Constants ◽  
Sex Hormone Binding Globulin ◽  
Precipitation Method ◽  
Microsoft Excel ◽  
Bioavailable Testosterone ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background: Bioavailable testosterone (BT), circulating testosterone not bound to sex hormone–binding globulin (SHBG), is thought to easily penetrate cells. We compared BT measurements obtained by assays with those obtained by calculation with different testosterone association constants. Methods: We obtained sera from 2 groups of hypogonadal men [group 1 (G1), 1421 samples; group 2 (G2), 170 samples] and a group of healthy men [group 3 (G3), 109 samples]. We added minute doses of [3H]testosterone to the sera, precipitated the SHBG-bound fraction of testosterone with ammonium sulfate (50% saturation), and then assayed serum BT (ABT) as %BT × total. Calculated BT (CBT) was determined with theoretical association constants of testosterone for SHBG (Ks = 1 × 109 L/mol) and albumin (Ka = 3.6 × 104 L/mol) and paired optimal Ks and Ka values obtained by use of Microsoft Excel software. Results: CBT calculated with theoretical constants differed from ABT by &gt;30% in 85.7% (G1), 84.1% (G2), and 77.9% (G3) of samples, and the mean CBT/ABT ratios were 1.57 (G1), 1.85 (G2), and 1.50 (G3) in spite of fairly good correlations. CBT calculated with paired optimal Ks and Ka differed from ABT by &lt;30% in 87.4% (G1), 87.5% (G2), and 97.5% (G3) of samples, and mean CBT/ABT ratios were 0.95–1.04. Conclusions: To obtain CBT values as close as possible to ABT, optimal paired association constants determined for each studied population must be used instead of the theoretical association constants. Considering the uncertainty of calculating BT, however, use of the ammonium sulfate precipitation method for determining BT is advisable.

scholarly journals A Self-Conditioner for Resin-Modified Glass Ionomers in Bonding Orthodontic Brackets

2007 ◽  
Vol 77 (4) ◽  
pp. 711-715 ◽  
Author(s):  
Samir E. Bishara ◽  
Adam W. Ostby ◽  
John Laffoon ◽  
John J. Warren
Keyword(s):  
Polyacrylic Acid ◽  
Testing Machine ◽  
Orthodontic Brackets ◽  
Shear Mode ◽  
Adhesive Remnant Index ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Self Etch ◽  
Bracket Failure

Abstract Objective: To evaluate a new self-etch conditioner used with resin-modified glass ionomers (RMGIs) in bonding orthodontic brackets. Materials and Methods: Sixty human molars were cleaned, mounted, and randomly divided into three groups. In group 1 (control), 20 orthodontic brackets were bonded to teeth using Transbond Plus Self-etching Primer; in group 2, 20 brackets were bonded using an RMGI with a 10% polyacrylic acid conditioner. In group 3, 20 brackets were bonded using Fuji Ortho LC with a new no-rinse self-conditioner for RMGIs. The same bracket type was used on all groups. The teeth were debonded in shear mode using a universal testing machine, and the amount of residual adhesive remaining on each tooth was evaluated. Analysis of variance was used to compare the shear bond strength (SBS), and the χ2 test was used to compare the Adhesive Remnant Index (ARI) scores. Results: There were no significant differences in the SBS (P = .556) between the groups. The mean SBS for Transbond Plus was 8.6 ± 2.6 MPa, for Fuji Ortho LC using 10% polyacrylic acid 9.1 ± 4.6 MPa, and for Fuji Ortho LC using GC Self-conditioner 9.9 ± 4.1 MPa. The comparisons of the ARI scores between the three groups (χ2 = 35.5) indicated that bracket failure mode was significantly different (P &lt; .001), with more adhesive remaining on the teeth bonded using Transbond. Conclusions: The new self-etch conditioner can be used with an RMGI to successfully bond brackets. In addition, brackets bonded with Fuji Ortho LC resulted in less residual adhesive remaining on the teeth.

Abstract TP308: Reduced Estimated Glomerular Filtration Rate And Outcomes Of Intracerebral Hemorrhage: The SAMURAI-ICH Study

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
TETSUYA MIYAGI ◽  
Masatoshi Koga ◽  
Hiroshi Yamagami ◽  
Satoshi Okuda ◽  
Yasushi Okada ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Intracerebral Hemorrhage ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Hematoma Expansion ◽  
Hematoma Volume ◽  
Nihss Score ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and Purpose: The association between chronic kidney disease and clinical outcomes in acute intracerebral hemorrhage (ICH) remains uncertain. We aimed to assess associations of renal dysfunction and outcomes in acute ICH patients treated with intensive BP lowering. Methods: The SAMURAI-ICH study was a prospective, multicenter, observational study. A total of 211 patients with acute supratentorial ICH were recruited. BP was targeted between 120 mmHg and 160 mmHg during initial 24 h using intravenous nicardipine. Glomerular filtration rate (eGFR) was calculated using admission serum creatinine. After 23 patients on maintenance hemodialysis were excluded, the remaining 188 were divided into 3 groups as follows: Group 1, eGFR of <60; Group 2, 60 to 75; and Group 3, ≥75 mL/min/1.73m 2 . Clinical outcomes were hematoma expansion of ≥33% at 24 h, neurological deterioration within 72 h (GCS decrement ≥2 points or NIHSS increment ≥4 points), and favorable (modified Rankin Scale [mRS] ≤2) and unfavorable (mRS ≥5) outcomes at 3 months. Results: Of 188 patients, 35 (18 women) were allocated to Group 1, 58 (20) to Group 2, and 95 (33) to Group 3. Significant differences among 3 groups were found in age (73.1±13.6, 63.3±13.2, 63.8±9.8 yo; p <0.001) and initial systolic BP (208.9±18.1, 201.2±15.6, 200.2±14.8 mmHg; p=0.018). Initial hematoma volume (14.9±11.9, 15.5±14.9, 14.3±12.3 mL) and initial median NIHSS score (14, 11, 13) were similar among 3 groups. For outcomes, significant differences among 3 groups were found in favorable outcome (17.7%, 51.7%, 41.3%; p=0.004) and unfavorable outcome (22.9%, 10.3%, 5.3%; p=0.021), but not in hematoma expansion (17.1%, 10.3%, 22.1%) and neurological deterioration (11.4%, 8.6%, 7.4%). After adjustment with initial hematoma volume, initial systolic BP and initial NIHSS score, eGFR <60 ml/min/1.73m 2 was inversely associated with favorable outcome (OR 0.20, 95% CI 0.07-0.54) and positively associated with unfavorable outcome (4.27, 1.36-13.53). Conclusions: Although decreased eGFR on admission was not associated with initial hematoma volume or initial NIHSS score, it was associated with poor outcomes at 3 months of ICH onset.

EVALUATION OF EFFICACY OF SILODOSIN VERSUS SILODOSIN WITH DEFLAZACORT IN EXPULSION OF LOWER URETERIC CALCULI

2021 ◽  
pp. 30-33
Author(s):  
Dev Yadav ◽  
P.N Agarwal ◽  
Sham Lal Singla ◽  
Kanwar Singh Goel ◽  
R. Talukdar ◽  
...  
Keyword(s):  
Plain Radiograph ◽  
Pharmacological Therapy ◽  
Urinary Stones ◽  
Controlled Study ◽  
Expulsion Rate ◽  
Ureteric Calculi ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objectives: To compare the efcacy of silodosin versus silodosin with deazacort in expulsion of lower end ureteric calculi, in terms of episodes of pain,stone expulsion rate,stone expulsion time ,analgesic requirements and side effects Introduction: Ureteric calculi represent 20% of urinary stones. Ureteroscopy and Shock wave lithotripsy proven the method of treatments for lower ureteric stones; however, they are expensive and not risk free. Aconservative approach is becoming more popular as a result of advances in pharmacological therapy which reduces the symptoms and helps in stone expulsion. We performed a randomized controlled prospective study to evaluate the efcacy of Deazacort in combination with alpha blocker silodosin in medical management of symptomatic lower Ureteric stones of ≤8 mm size. Material and methods: A prospective randomised controlled study was conducted on 60 patients, age ≥ 18 , who had unilateral lower ureteric stone of ≤ 8 mm. Patients were divided into three groups. Group 1 received silodosin 8 mg for 14 days,Group 2 received silodosin 8 mg plus deazacort 30mg daily for 14 days and Group 3 (control) received diclofenac potassium (75 mg ) when required. The patients were followed-up by ultrasonography ,plain radiograph KUB and computed tomography (in some cases). Results: There was a higher stone expulsion rate of 95% in Group 2 as compared to Group 1(85%) and Group 3(35%) . Group 2 showed a signicant advantage for stone expulsion time ,decreased pain episodes and analgesic use. Two patients, one in group 1 and group 2, reported retrograde ejaculation. Conclusion: The results showed that silodosin with deazacort , increases the stone expulsion rate, decrease the stone expulsion time, decreases the mean number of pain episodes and decreases the mean analgesic dosage requirement. But larger study is required to establish its efcacy for expulsion rate which will be statistically signicant.

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