scholarly journals EFFICACY OF TAMSULOSIN IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA IN TERMS OF TRIAL WITHOUT CATHETER, A RANDOMIZED CONTROL TRIAL

2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Farhan Khan ◽  
Usman Qamar ◽  
Muhammad Saifullah ◽  
Muhammad Sheraz Javed ◽  
Ahsan Ali Arain ◽  
...  

BACKGROUND & OBJECTIVE: Benign prostatic hyperplasia (BPH) is a prevalent cause of voiding problems in older males and is most commonly associated with acute urological complications, most important of which is acute urinary retention (AUR). α1- antagonists are the treatment of choice for the management of patients with BPH. Our objective was to evaluate the efficacy of tamsulosin for the treatment of patients with AUR due to BPH in terms of trial without catheter (TWOC). METHODOLOGY: This randomized control trial was conducted in a Urology Section, Department of Surgery, SIUT Karachi, from 21-12-2016 to 20-06-2017. Our study included 136 patients who presented AUR due to BPH as per selection criteria. Patients were randomized into two groups. Group A patients received tamsulosin (0.4 mg), and group B patients received placebo drug immediately after insertion of Foley catheter. The success of TWOC was evaluated after 3 days of medical treatment. Statistical analysis was carried out using SPSS v20.0. RESULTS: The mean age of the study patients was 59.45 + 8.05 years. The mean duration of BPH disease was 15.39 + 6.84 months. There were 33 (48.5%) patients in the tamsulosin group in which TWOC was successful and only 22 (32.4%) patients in placebo group in which TWOC was successful (p-value 0.04). There was no effect of age and duration of BPH disease on the outcome of this study. CONCLUSION: Tamsulosin is effective for the treatment of patients with AUR due to BPH.

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Beni Indra ◽  
Untung Widodo ◽  
Yunita Widyastuti

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation


2019 ◽  
Vol 33 (1) ◽  
Author(s):  
Sidra Malik ◽  
Iqra Zaib ◽  
Omer Farooq ◽  
Kanwal Hanif

Objective: To Compare the efficacy of 2 different patching regimens in amblyopic children and highlight the factors affecting compliance. Materials & Methods: The randomized control trial was conducted in Eye OPD SKBZ Hospital Muzaffarabad from September 2017- March 2018. Analysis was limited to children 4 to 16 years of age with unilateral amblyopia. Personal information, visual acuity with and without correction, Cycloplegic refraction & subjective refraction was noted. Children with amblyopic eye acuity of 20/40 to 20/200 (mean 0.56 log MAR, approximately 20/63) and inter ocular acuity difference of 2 or more lines were specified to get either 2 hours (Group A) or 6 hours (Group B) of daily patching, combined with 1 hour of near visual activities per day. Follow up period was 2 weeks, 4 weeks and 3 months. Results:     Out of 72 children 44(61.1%) were males and 28(38.9%) were females. The mean age was 10.25 ± 0.67 years.  Mean visual acuity was 20/63(+0.5 log Mar) in both groups. In group A, 66.7 % and in group B 83.3% of patients showed improvement. The mean difference of BCVA was 2.77 ± 1.28 SD and 3.41±3.16 SD in group ‘A’ and group ‘B’ respectively. Group A and B showed improvement of 3.0 and 2.0 lines respectively. Both groups showed a poor compliance of 11.2 %. Conclusion: 2 hours of patching along with 1 hour of near activity is sufficient to treat amblyopia as compared to 6 hours of patching. Firstly, screening should be done to diagnose amblyopia at early stage. Secondly compliance is found to be a single most important factor to improve outcomes.


2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Yongqi He ◽  
Siquan Zhu ◽  
Ming Chen ◽  
Dejiao Li

Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism) among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions.Methods. 120 patients (134 eyes) underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry.Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively ( .05), which showed no statistic significance difference.Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.


1969 ◽  
Vol 2 (1) ◽  
pp. 96-99
Author(s):  
Liaqat Ali ◽  
Mir Alam Jan ◽  
Sarhad Khan ◽  
Khursheed Anwar

Objectives: To compare the resection time and resected volume of the prostate in patients who weresubjected to video Trans-urethral resection of prostate (TURP) and conventional TURP, and to determinethe difference in the duration of bladder irrigation during post-operative period for conventional TURP andvideo TURP. Study Design: Comparative randomized control study. Methods: The study was conducted in the Department of Urology at Pakistan Institute of Medical Sciences(PIMS) Islamabad from Is' March 2002 to 28,h February 2003. Total number of 100 patients were equally Kdivided into two groups. Group ’A’ comprising of 50 patients (Control) were subjected to ConventionalTURP and Group 'B' comprising of 50 patients (Case) were subjected to video TURP respectively. Thesample was randomized by the last digit of the hospital admission number, Even number was allocated togroup 'A' and Odd number to group 'B'. The data was recorded on structured proforma and was analyzed onSPSS. ' ; Results: The mean age of the patients was 65.5 years with the range of 42-96 years. The Mean resection timefor conventional TURP was 36.03 minutes and for video TURP was 37.27 minutes ( P value = 0.068 ). Themean resected volume for conventional TURP was 18.5 gm and for video TURP was 23.65gm ( P value =0.01 ). The post operative irrigation of the bladder with 0.9% saline was required for 3.32 days inconventional TURP, while it was required for 1.57 days in video TURP ( P < 0.05 ). There was no TURPsyndrome recorded in both the groups and the mean hospital stay for both the group was equal i.e. 4th Postoperative day as per protocol of our department. Conclusion: The video TURP has opened up a new Approach in endourology. It is more effective inresection than conventional TURP and bears the same safety of resection time as conventional TURP. Key Words: Prostate,TURP, Endourology, Video TURP


2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27


2021 ◽  
Vol 8 (31) ◽  
pp. 2875-2879
Author(s):  
Sucheta Panigrahi ◽  
Acharya Suryakanta Pattajoshi ◽  
Sanjay Kumar Mahapatra ◽  
Raja Kumar Subudhi P ◽  
Biswajit Sahu

BACKGROUND In this study we wanted to compare the clinical outcomes in terms of symptom improvement and perioperative results of monopolar and bipolar trans urethral resection of prostrate (TURP) for benign prostatic hyperplasia (BPH) and evaluate the advantages of bipolar transurethral resection over the monopolar resection. METHODS A total of 150 patients who underwent trans urethral resection of prostate (TURP) surgical procedure, (n = 75 for monopolar TURP) and (n = 75 for bipolar TURP) for BPH enrolled between December 2018 to November 2020 at the Department of Urology in VSSIMSAR, Burla, Odisha. RESULTS Significant differences were found in operating time in minutes (45.11 ± 4.029 vs 41.99 ± 5.020, P < 0.025) between monopolar and bipolar TURP. The mean sodium falls in post-operative period in bipolar and monopolar TURP was 7 Meq and 3 Meq respectively which was statistically significant (P - value less than 0.05). Bipolar TURP is equally effective as monopolar in reducing the international prostate symptom score (IPSS), improvement in quality of life, maximum urinary flow rate. Trans urethral resection (TUR) syndrome was reported in two patients who had undergone monopolar resection without any incidence in bipolar group. 3 patients in monopolar group developed clot retention compared to 1 in bipolar group in post-operative period. Fall in haemoglobin (Hb) and packed cell volume (PCV) was more with monopolar group but insignificant. CONCLUSIONS Bipolar TURP is safe and equally effective as monopolar TURP with advantage of shorter operative time and absence of dilutional hyponatremia and TUR syndrome, but needs large randomized trials with long follow up to confirm its efficacy and safety. KEYWORDS Monopolar TURP; Bipolar TURP; Benign Prostate Hyperplasia


2015 ◽  
Vol 87 (3) ◽  
pp. 238
Author(s):  
Hassan El-Tatawy ◽  
Tarek Gameel ◽  
Mohammed Abo El-enen ◽  
Ayman Hagras ◽  
Ayman Mousa ◽  
...  

Objectives: To evaluate the impact of the prostatic-urethral angulation (PUA) on the treatment efficacy of selective alpha-1A receptor blocker in male patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Materials and methods: A total of 80 patients with LUTS/BPH and with mean age 53.3 ± 6.3 (range 47-70) were included in our prospective comparative study. The patients were classified into 2 groups as a consecutive cases 40 in each one depending on the PUA either ≤ 35° (group A) or &gt; 35° (group B). PUA and different prostatic parameters were measured using transrectal ultrasound. Prostate-specific antigen (PSA), the International Prostate Symptom Score and quality of life score (IPSS/QoL score), maximum flow rate (Q<sub>max</sub>), and postvoid residual (PVR) volume were compared between the groups. The clinical significance of PUA was evaluated after 8 weeks of medical treatment with tamsulosin hydrochloride 0.4 mg daily. Results: Baseline evaluation (pre-treatment) for both groups were comparable to each other with no clinically significant difference regarding age, PSA, IPSS/QoL score, Qmax and PVR volume (P-value &gt; 0.05). Comparison of parameters after 8 weeks showed that tamsulosin hydrochloride improved the total IPSS and all subscores (P &lt; 0.001), QoL (P = 0.001), Q<sub>max</sub> (P = 0.002), and PVR (P = 0.04) in group A (Table 1). Conclusion: Tamsulosin hydrochloride appears to be less effective in improving IPSS/Qol score, Qmax and PVR in patients with lager PUA. The PUA might be a predictor for the treatment efficacy of α-blockers and more studies are warranted in the future before the final conclusion.


2019 ◽  
Vol 8 (2) ◽  
pp. 74-78
Author(s):  
Muhammad Zubair ◽  
Ghulam Saqulain ◽  
Arfat Jawaid

Background: Acute Otitis Media (AOM) is a common upper respiratory tract infection (URTI) in children and usually presents with fever and otalgia. AOM is characterized by congested tympanic membrane and possible increase in temperature, which might be picked up by infrared tympanic thermometry. The objective of this study was to compare the temperature difference of tympanic membrane of affected ear with the unaffected ear and axilla in unilateral acute otitis media, and compare it with the control group.Material and Methods: This case control study comprised of 200 cases of both genders, aged up to 5 years. They were divided into two groups; Group A included 100 clinically diagnosed cases of acute otitis media (AOM), who reported in the ENT Outpatient Department (OPD) and Group B included 100 controls who presented in General Filter Clinic with no ear complaints. Cases with chronic ear disease, ear discharge, and use of local drugs including ear drops, impacted ear wax, tragal tenderness and congenital malformations of the ear were excluded by taking a detailed history. Clinical examination including otoscopy by an expert was done before subjecting patients to axillary and tympanic thermometry measurements and data recording. Data was collected and tabulated using Microsoft Excel Worksheet and analyzed by SPSS 16. Qualitative data like gender were presented as percentage and ratio, while means and standard deviation were calculated for the quantitative data. Difference between the means of experimental and control groups were analyzed by independent sample t-test and P value of less than or equal to 0.05 was taken as significant.Results: This study included 100 cases of unilateral AOM and 100 normal controls without AOM. In patients with AOM, the mean temperature difference between the affected ear and axilla was 1.41ºF as compared to 0.075ºF in controls (p=0.026). While the mean temperature difference between the affected ear and other ear was 0.65ºF as compared to 0.19ºF in controls (p=0.069).Conclusion: In acute otitis media, the temperature of affected ear is significantly higher than axilla but was not significantly higher than the other ear. The finding may help establish thermometry as a diagnostic tool in clinics manned by doctors not competent to do otoscopy.


2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.


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