Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

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 > 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 > 0.05). Comparison of parameters after 8 weeks showed that tamsulosin hydrochloride improved the total IPSS and all subscores (P < 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.

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Risk factors for bladder calculus in patients with benign prostatic hyperplasia: a retrospective single-center study

10.21203/rs.2.24560/v1 ◽

2020 ◽

Author(s):

Xin Sun ◽

Dexin Yu ◽

Zhangjun Cao ◽

Dongdong Xie ◽

Liangkuan Bi

Keyword(s):

Risk Factors ◽

Benign Prostatic Hyperplasia ◽

Multivariate Analyses ◽

Specific Antigen ◽

Significant Risk ◽

Prostatic Hyperplasia ◽

Bladder Calculus ◽

Total Prostate Specific Antigen ◽

Significant Difference ◽

Group 2

Abstract Background: To explore the risk factors that lead to the formation of bladder calculus in patients with benign prostatic hyperplasia (BPH). Methods: Retrospective study was performed between June 2017 and October 2019, 103 patients with BPH who underwent transurethral resection of the prostate (TURP) were included. Patients with BPH were divided into two groups: 32 patients with bladder calculus in group1 and 71 patients without bladder calculus in group2. Characteristics of both groups were compared and univariate and multivariate analyses were performed to investigate the association between BPH with or without bladder calculus. Results: There was no significant difference between the two groups regarding age, duration of BPH, body mass index (BMI), total prostate volume (TPV), total prostate-specific antigen (TPSA), International prostate symptom score (IPSS), serum albumin, hemoglobin, uric acid, urinary tract infection, diabetes, and hypertension. The patients' serum creatinine and acute urinary retention (AUR) were significantly lower, while intravesical prostatic protrusion (IPP) was significantly higher in group 1 than group 2. Multivariate analyses revealed that IPP and AUR were significant risk factors for the formation of bladder calculus in patients with BPH. For IPP, the receiver operating characteristic (ROC) curve showed that the cut-off value of the highest risk of the formation of bladder calculus was 11.5 mm. Conclusions: Our study indicated that IPP and AUR were independent risk factors that were closely linked with the incidence of bladder calculus in BPH patients.

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Impact of Whatsapp in improving learning among 9th semester MBBS students

Medpusle International Journal of Surgery ◽

10.26611/1061917 ◽

2021 ◽

Vol 19 (1) ◽

pp. 27-30

Author(s):

Y Satish Reddy ◽

Keyword(s):

Undergraduate Students ◽

Control Group ◽

P Value ◽

Study Group ◽

Opinion Poll ◽

Didactic Teaching ◽

Significant Difference ◽

Group A ◽

The Mean ◽

The Impact

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students

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Correlation Between the Prostate-Specific Antigen Level and Bone Metastasis in Prostate Cancer. (Retrospective Study)

10.47363/jcrrr/2020(2)113 ◽

2020 ◽

Vol 2 (2) ◽

pp. 1-6

Author(s):

Adel Hassan Mohamed Hassan ◽

◽

Tarek Huissen kamel ◽

Nesreen Ahmed Mosalam ◽

◽

...

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

P Value ◽

Asymptomatic Patients ◽

Significant Difference ◽

Group A ◽

Group B ◽

Age Range

Background: The most common non-cutaneous malignancy for men is Prostate cancer (PCa). PCa diagnosed by biopsy and PSA detection. Bone metastasis (BM) causes a lot of complications, such as bone pain and pathological fracture that cause overall compromised quality of life. Bone scintigraphy (BS) is commonly used for monitoring and detection of (BM). Objective: To correlate between serum PSA level and BM in PCa patients on series of 250 patients through detecting PSA levels and BSs. Patients and Methods: In the present study Patients were stratified (group A) & (group B) according to BM. Out of the 250 patients, 180 patients (Group A localized PCa) were with age range from 57 -92 years, the remaining 70 patients (Group B metastasis PCa) the age range was 53-88 years. Prostate specific antigen (PSA) level for both groups were detected. Results: By comparing group A and group B there was a highly significant difference in PSA value in favor of positive BS group (p-value < 0.001). The present study recommends BS in asymptomatic patients with PSA above 60 Ng/ml. Conclusion: PCa is the most common malignant non-cutaneous tumor for men. The most common spread for PCa is bone spread. Age doesn’t correlate with BM in PCa patients. PSA total show highly significance with BM in PCa patients. PSA cut-off value for BM in PCa patients was 60 Ng/ml so it was recommended to perform BS for asymptomatic patients with PSA total above 60 Ng/ml.

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Continuous versus Intermittent Tamsulosin Therapy in Men with Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia: A Randomized Control Trial

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v15i1.48635 ◽

2020 ◽

Vol 15 (1) ◽

pp. 22-26

Author(s):

SM Shameem Waheed ◽

Mohammad Abdur Rakib ◽

Md Shahidul Islam ◽

Mohammad Abdur Rakib ◽

Md Ashif Chowdhury ◽

...

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Prostatic Hyperplasia ◽

Urinary Tract Symptoms ◽

Significant Difference ◽

Group A ◽

Group B ◽

Lower Urinary

Introduction: Benign prostatic hyperplasia (BPH) is the most common benign tumour in men. About 50% of men at the age of 50 years develop BPH and about half of them report to the doctors with some form of lower urinary tract symptoms (LUTS). Objectives: To see the therapeutic effect of Tamsulosin on alternate day administration in comparison to daily dose for men who had been suffering from LUTS due to BPH. Materials and Methods: This clinical trial was carried out at Combined Military Hospital, Dhaka in a consecutive fashion for about 18 months. A total of 152 patients were selected from outpatient department and after assessing them through inclusion and exclusion criteria and grouped randomly in three groups Group-A (50 patients), Group-B (50 patients) and Group C (52 patients); all the patients were treated with Tablet Tamsulosin (0.4mg) daily for first three months. Then next 15 months they were treated as; Group-A received Tablet Tamsulosin (0.4mg) daily, Group-B received Tablet Tamsulosin (0.4mg) every alternate day and Group C received placebo Tablet (Folic acid 5 mg) daily. Data were collected at the beginning and end of 3rd month, 4th month, 7th month and 18th month of study, in the form of international prostate symptom score (IPSS), maximum urinary flow per second (Qmax) and post-voidal residue (PVR). Results: This study showed that at the initial three month, IPSS score declined in all three groups, Qmax improved and PVR reduced in all groups. In next phase of study; in Group-A patient there was progressive and significant improvement of all parameters (IPSS, Qmax and PVR) at the end of study. In Group-B patient also showed similar result at the end of study. In Group-C patient showed statistically significant difference in outcome in relation to Group-A and Group-B i.e. more in IPSS, less in Qmax and increase in PVR. Conclusion: With this study it is clearly evident that tamsulosin (0.4mg) therapy significantly improves symptoms of men suffering for LUTS due to BPH. And alternate day therapy having similar therapeutic outcome in relation to every day therapy. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 22-26

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The significance of TPSA, free to total PSA ratio and PSA density in prostate carcinoma diagnostics

Acta chirurgica iugoslavica ◽

10.2298/aci0704105m ◽

2007 ◽

Vol 54 (4) ◽

pp. 105-107

Author(s):

B. Milkovic ◽

J. Hadzi-Djokic ◽

Z. Dzamic ◽

T. Pejcic

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Tumor Markers ◽

Prostate Carcinoma ◽

Statistical Significance ◽

Specific Antigen ◽

Prostatic Hyperplasia ◽

Operating Characteristics ◽

Psa Density ◽

Significant Difference

Prostate-specific antigen (PSA) is the one of the most valuable tumor markers for the early detection and management of prostate carcinoma, but not an ideal one because of poor specificity in the case of prostatic hypertrophy and other benign conditions. In order to overcome this drawback some other parameters as is free to total ratio (F/T) PSA and PSA density (PSAD) are introduced. It has been investigated in 60 patients, 18 of them are proved to be found prostate cancer and other 42 were identified as benign prostatic hyperplasia. Patients with CaP had TPSA median of 11.4 ng/ml and the others with benign prostatic hyperplasia (BPH) had 6.9 ng/ml. In these two groups there was statistical significant difference (p 0.01). By receiver operating characteristics curve (ROC) estimated cutoff for TPSA was 4.0 ng/ml with 95% sensitivity, 30% specificity and area covered by ROC was in amount of 0.76. Median F/T ratio for patients with prostate cancer was 0.10, and for benign prostatic hyperplasia patients it was 0.25.For these values there is also statistical difference (p). Using ROC cutoff for F/T PSA was determined at the value of 0.18 with sensitivity 95%, specificity 80% and area under the curve (AUC) 0.93. Median for PSAD in the group with CaP was 0.38 and in the BPH group was 0.16. There was statistical significance within those two groups. In conclusion F/T PSA, PSAD and TPSA are valuable tumor markers in distinguishing patients with CaP ant those without with modestly raised TPSA. Also F/T PSA showed up as better marker than TPSA and PSAD in investigated group of patients.

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Influence of Processing Techniques on Microhardness and Impact Strength of Conventional and Reinforced Heat Cured Acrylic Resin: A Comparative Study

Materiale Plastice ◽

10.37358/mp.21.3.5521 ◽

2021 ◽

Vol 58 (3) ◽

pp. 239-246

Author(s):

Aisha Kiran ◽

Faiza Amin ◽

Muneeb A Lone ◽

Imran Alam Moheet ◽

Maham M Lone ◽

...

Keyword(s):

Impact Strength ◽

Acrylic Resin ◽

Water Bath ◽

P Value ◽

Dry Heat ◽

Heat Cure ◽

Significant Difference ◽

Group A ◽

Processing Techniques ◽

The Impact

This study determined and compared the influences of various processing techniques including air circulating oven (ACO), dry heat oven (DHO) and water bath (WB) on the impact strength (IS) and microhardness (HV) of the conventional heat cure acrylic resin (CHCAR) and rubber reinforced heat cure acrylic resin (RRHCAR). Samples were fabricated using CHCAR (control Group A; n=114) and RRHCAR (experimental Group B; n=114). Group A and B were further divided into subgroups according to processing techniques: ACO, DHO and WB (n=38 each) for both testing variables microhardness and impact strength (n=19 each). Charpy testing machine and Vickers microhardness tester were utilized. Analysis of variance was applied to determine the presence of significant differences among processing techniques while P-value ≤ 0.05 was considered as significant. Water bath (P-value [0.001) and DHO technique (p-value [0.001) showed significant differences between both groups� impact strength and microhardness. Microhardness of group A and B showed a significant difference (p-value 0.002) when processed by ACO. Impact strength and micro hardness were improved in RRHCAR compared to CHCAR processed by ACO and DHO in comparison to WB technique. Rubber reinforced heat cure acrylic resin revealed improvement in the impact strength and microhardness. The air circulating oven exhibited highest microhardness in both testing materials. Dry heat oven showed improved values of impact strength in conventional heat cure acrylic resin.

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Correlation Between the Prostate-Specific Antigen Level and Bone Metastasis in Prostate Cancer. (Retrospective Study)

10.47363/jcrr/2020(2)113 ◽

2020 ◽

pp. 1-6

Author(s):

Adel Hassan Mohamed Hassan ◽

◽

Tarek Huissen kamel ◽

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

P Value ◽

Asymptomatic Patients ◽

Significant Difference ◽

Group A ◽

Group B ◽

Age Range

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Association of Serum PSA Levels with Histopathological Pattern of Prostate Lesions

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i2.362 ◽

2019 ◽

Vol 8 (2) ◽

pp. 92-95 ◽

Cited By ~ 1

Author(s):

Afra Samad ◽

Nudrat Fayyaz ◽

Ayesha Siddiqa ◽

Naseem Akhter ◽

Rabia Saeed ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

Prostate Carcinoma ◽

Histopathological Examination ◽

Prostate Gland ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Intraepithelial Neoplasia ◽

Prostatic Intraepithelial Neoplasia ◽

Prostatic Hyperplasia ◽

P Value

Background: Pathological changes that mainly affect prostate gland are prostatitis, benign prostatic hyperplasia (BPH) and cancerous lesions. Digital rectal examination (DRE), Transrectal Ultrasonography (TUS), and prostate specific antigen (PSA) followed by histopathological examination, are routinely used tests for diagnosis of prostate lesions. The aim of the present study is to determine the role of serum PSA levels in differentially diagnosing the different types of prostate lesions.Material and Methods: This retrospective (observational) study was conducted in Ibn-e-Sina Hospital Multan. Data of 2189 patients who were operated from 2007 to 2017 due to prostatic lesions were included in this analysis. Patients with BPH, prostatitis, prostate carcinoma and Prostatic Intraepithelial Neoplasia (PIN) were grouped according to serum PSA levels (ranging from 0 to >100 ng/ml) into five groups. Frequencies and percentages were calculated for different histopathological findings. Association of PSA levels with different histological patterns was determined with chi-square test with P-value < 0.05 taken as significant difference.Results: Mean age of patients was 62.45+10.64 years. On histopathology, BPH was diagnosed in 1676 (76.56%) patients, prostatitis in 133 (6.07%), carcinoma in 378 (17.26%) and PIN in 02 (0.09%) patients, respectively. Serum PSA levels of 4.01-10 ng/ml were found in 1050 (62.64%) BPH patients and in 59 (44.36%) prostatitis patients. Serum PSA levels of 10.01-20 ng/ml were found in only 40 (2.4%) BPH patients, 47 (35.33%) prostatitis patients, 22 (5.82%) carcinoma patients and in 1 (50.0%) PIN patient. Serum PSA levels of 20.01-100 ng/ml were found in 32 (1.9%) BPH patients, 11 (8.27%) prostatitis patients, 302 (79.89%) carcinoma patients, and in 1 (50.0%) PIN patient. Serum PSA levels of >100 ng/ml were absent in patients with BPH and PIN, and present in 1 (0.75%) prostatitis and 54 (14.28%) carcinoma patients.Conclusion: Benign prostatic hyperplasia was the commonest lesion in our patients (76.56%) with serum PSA levels >10 ng/ml reported in all patients with prostate carcinoma and prostatic intraepithelial neoplasia (PIN) patients.

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Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients

Journal of International Medical Research ◽

10.1177/0300060520986284 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098628

Author(s):

Chen Xu ◽

Gang Zhang ◽

Jin-jin Wang ◽

Chun-xian Zhou ◽

Min-jun Jiang

Keyword(s):

Benign Prostatic Hyperplasia ◽

Elderly Patients ◽

Prostate Volume ◽

Specific Antigen ◽

Urine Volume ◽

Prostatic Hyperplasia ◽

Antigen Level ◽

Residual Urine Volume ◽

Safety And Efficacy ◽

Total Prostate Specific Antigen

Objective To assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia. Methods Twenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level. Results Selective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%. Conclusions PAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.

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The Impact of an Educational Program on Medical Students’ Knowledge and Awareness of Elder Abuse

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211016487 ◽

2021 ◽

Vol 8 ◽

pp. 238212052110164

Author(s):

Abbie West ◽

Cara Cawley ◽

Elizabeth Crow ◽

Alexis M. Stoner ◽

Natalie M. Fadel ◽

...

Keyword(s):

Medical Students ◽

Educational Program ◽

Survey Methodology ◽

Elder Abuse ◽

P Value ◽

Significant Difference ◽

Survey Results ◽

Second Year ◽

College Of Osteopathic Medicine ◽

The Impact

Objective: Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse. Methods: This study used a pre and post survey methodology to evaluate students’ knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference. Results: First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge ( P-value < .001) and awareness scores ( P-value < .001) in all students. Conclusion: These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.

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