A Comparison of Effectiveness of Thai Traditional Massage and Tamsulosin in Lower Urinary Tract Symptoms: A Randomized Controlled Trial

The prospective clinical, non-inferiority study aimed to investigate the effectiveness of Thai traditional massage on lower urinary tract symptoms (LUTS) compared with Tamsulosin in Thai men. It was conducted on men aged 50 to 75 years old with LUTS (N = 45). Participants were blocked four randomly assigned into 2 groups. The control group (n = 25) was received 0.4 mg Tamsulosin daily and the study group (n = 20) was given Thai traditional massage for 4 weeks. The efficacy evaluation was performed by the International Prostate Symptoms Score (IPSS), a Thai version of the World Health Organization Quality of Life Questionnaire (WHO-QoL Brief), Uroflowmetry, and Post-void residual urine (PVR) at baseline and end of study. The background characteristics of participants were not significantly different between groups. Both interventions relieved LUTS in the total IPSS and the quality of life score associated with urination were decreased, described as symptoms and quality of life due to urination improvement after 4 weeks of intervention. Interestingly, the Thai traditional massage has significant improvement in total IPSS and voiding score (p < .05). Additionally, the time to peak flow rate, peak flow rate (Qmax), average flow rate (Qave) and voided volume of both interventions were improved with no statistical significance. PVR was decreased in both interventions. The WHO-QoL brief score was improved the total score. There was no significant difference in terms of uroflowmetry, PVR, and WHO-QoL brief scores compared between groups. The result suggests that Thai traditional massage has the potential to be an alternative treatment for LUTS.

Effect of combined glucocorticoid therapy on bronchial asthma dynamics

This work is aimed to compare the effectiveness of parenteral and inhalation bronchial asthma treatment in combination with glucocorticosteroids and bronchodilators. The study was conducted in 2020 in Botkin City Clinical Hospital (Moscow, the Russian Federation). Case histories of 106 patients diagnosed with bronchial asthma exacerbation of moderate severity were analyzed. Patients were divided into two equal groups based on the therapy method: (1) Group 1 received systemic glucocorticosteroids parenterally in combination with inhalation glucocorticosteroids; (2) Group 2 received systemic glucocorticosteroids parenterally, but inhalation therapy was performed with a nebulizer. Clinical manifestations of bronchial asthma have been recorded. During hospital admission, the breath rate was 22.0 for Group 1 and 21.5 for Group 2, P ≥ 0.05, and heart rates were 93.0 and 92.5, respectively (P ≥ 0.05). All indices (blood saturation, breath rate, peak output rate) in Group 1 remained unchanged 4 h after the start of the therapy, while in Group 2, peak flow rate changed to 53.5% with a median increase of 72.0 ml over 4 h, P ≤ 0.05. On Day 3, patients of Group 1 demonstrated a peak flow rate of 59.5%, P ≤ 0.05, and on Day 10, patients of Group 2 had a peak output rate of 53.0 and 59.5%, respectively (P ≤ 0.05). Systemic glucocorticoids were eliminated in 47 patients of Group 1 and in all patients of Group 2. The treatment tactics applied in Group 2 resulted in faster and more significant improvement in patients diagnosed with bronchial asthma exacerbation. Both treatment regimens showed high results.

Application and Value of Dynamic Volume CT Multiparameter Imaging in the Diagnosis of Traumatic High-Flow Penile Abnormal Erection

Objective. To explore the clinical application of dynamic volume CT multiparameter imaging in the observation of penile hemodynamics in patients with abnormal vascular erections. Methods. 90 patients with suspected vascular abnormal erections treated in our hospital from January 2016 to January 2020 were included in the study, and 40 patients with psychologically abnormal erections were selected for the control. The corpus cavernosum injection vasoactive drug test (ICI) and dynamic volume CT and Doppler ultrasound were used to test the hemodynamics of the corpus cavernosum of all selected patients and to analyze the changes of penile length, circumference, systolic peak flow rate, diastolic peak flow rate, and blood flow resistance index in different types of penile erection disorder patients before and after ICI test. Results. Among the 90 patients with suspected vascular abnormal erection, 34 patients had arterial abnormal erection, 25 patients had venous abnormal erection, and 31 patients had mixed vascular abnormal erection. In patients with arterial abnormal erection and mixed vascular abnormal erection, penile cavernous body diameter, PSV, and abnormal erection V are smaller than those in patients with venous abnormal erection and psychological abnormal erection, while arterial abnormal erection and psychological abnormal erection are obviously higher in RI than venous abnormal erection and mixed vascular abnormal erection, and the difference is statistically significant ( P < 0.05 ). Before the ICI test, there was no significant difference in the penis circumference and length between the four groups of patients with arterial abnormal erection, venous abnormal erection, mixed vascular abnormal erection, and psychological abnormal erection ( P > 0.05 ); after the ICI test, patients with arterial abnormal erections had significantly shorter penis perimeter and penis length than those with venous abnormal erections, mixed vascular abnormal erections, and psychological abnormal erections ( P < 0.05 ). Conclusion. Dynamic volume CT can clearly reflect the penile hemodynamic state of patients with vascular abnormal erections, provide a powerful diagnostic basis for accurately and effectively determining the classification of vascular abnormal erections, and be worthy of popularization and clinical use.

Benign prostatic hyperplasia: Who will benefit from surgical intervention? A single center experience

Background: To evaluate the pre-operative factors affecting clinical response to prostate surgery in men with benign prostatic hyperplasia (BPH). Materials and methods: In this prospective cohort study, 172 patients who underwent surgical intervention for BPH (either as open prostatectomy ( n = 78) or monopolar-trans-urethral resection of prostate ( n = 94) from February 2017 to October 2019 were consecutively enrolled. Pre-operative conventional three-lumen urodynamic study and transabdominal sonography were performed for all patients to determine peak flow rate (Qmax), detrusor pressure at the peak flow rate (PdetQmax), post-void residual volume (PVR), presence of detrusor overactivity (DO), prostate volume and median lobe size, and bladder wall thickness with empty and full bladder. Uroflowmetry and cystoscopy were performed during follow-up, whenever indicated. Successful surgical outcome was defined as subjective satisfaction of the patient and a Qmax of more than 15 ml/s on post-operative uroflowmetry. Results: At 1-year follow-up, complete resolution of lower urinary tract syndrome (LUTS) was detected in 138 (80.2%) patients; however, 21 (12.2%) still had pure obstructive LUTS, 9 (5.2%) had pure storage LUTS, and 4 (2.3%) were still suffering from both storage and obstructive LUTS. After performing multivariable analysis, shorter duration of pre-operative medical treatment and higher pre-operative bladder contractility index (BCI) were found to be independent predictors of successful surgery ( p = 0.012 and p < 0.001, respectively). Results of the ROC curve analysis showed that a preoperative BCI level more than 90.95 and pre-surgical medical treatment duration less than 14.45 months have the most specificity and sensitivity to predict the success of surgical outcome. We also observed that the probability of recovery decreased considerably over time following surgery. Conclusion: Shorter duration of pre-operative medical treatment and increased pre-operative BCI can independently predict favorable outcome of BPH surgery. These factors could be used for better patient management and appropriate planning and consultation before BPH surgery.

Independent Urine Measurement Based on Internet of Things

This study aims to create an independent urine measuring instrument based on the internet of things (IoT). This study was to see the differences in uroflometric measurements using an independent urine measuring based IoT tool compared to uroflometry in the urology clinic. The sampling method used was consecutive sampling with a total of 32 respondents. Uroflometry measurements were carried out twice, first using an independent urine measuring device based on the IoT, secondly using the standard uroflometric peak flow rate examination in the urology clinic. The results of measuring the average amount of urine per second using an independent urine measuring device based on IoT 22.22 ml / second, the average peak flow rate using uroflometry in the urology clinic is 23.97 ml / second, this shows that an independent urine measuring instrument based on IoT is not significantly different from uroflometry in urology polyclinic with a p value of 0.411, which indicates Ho was accepted, meaning there was no difference between the mean amount of urine per second and the average peak flow rate using uroflometry in the urology clinic. This study therefore concludes that an independent urine measuring devise based on the IoT instrument is effective for measuring urine emission per second. Suggestion: Follow up on the patent and legality of measuring instruments Keywords: independent urine measuring instrument, internet of things(IoT), uroflometry, urethral stricture

Correlation of intravesical prostatic protrusion with severity of lower urinary symptoms among patients with benign prostatic hyperplasia

Background Benign prostate hyperplasia (BPH) is characterized by an increase in the number of epithelial and stromal cells in the periurethral area of the prostate. Lower urinary tract symptoms (LUTS) often develop as a manifestation of bladder outlet obstruction (BOO) due to benign prostate enlargement. When the prostate enlarges, protrusion into the bladder often occurs as a result of morphological changes of the gland. Prostatic protrusion into the bladder can be measured with ultrasound as intravesical prostatic protrusion (IPP). There are studies that have shown IPP as a reliable predictor of bladder obstruction index (BOOI) as measured by pressure flow studies. IPP is thereby reliable in assessing the severity of BOO in patients with BPH. The severity of symptoms in patients with BPH can be assessed through several scoring systems. The most widely used symptoms scoring system is the International Prostate Symptoms Score (IPSS). The aim of this study is to determine the correlation of IPP with IPSS in men with BPH at our facility. Methods The study was a cross-sectional observational study that was conducted at the Division of Urology, Department of Surgery, in our facility. The study was conducted on patients greater than 50 years LUTS and an enlarged prostate on digital rectal examination and/or ultrasound. All consenting patients were assessed with the International Prostate Symptoms Score (IPSS) questionnaire, following which an abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), prostate volume (PV) and post-void residual (PVR) urine. All the patients had uroflowmetry, and the peak flow rate was determined. The data obtained were entered into a proforma. The results were analyzed using Statistical Package for Social Sciences (SPSS) software package version 20. Results A total of 167 patients were seen during the study period. The mean age was 63.7 ± 8.9 years, with a range of 45–90 years. The mean IPSS was 18.24 ± 6.93, with a range of 5–35. There were severe symptoms in 49.1%, while 43.1% had moderate symptoms and 7.8% had mild symptoms. The overall mean IPP was 10.3 ± 8 mm. Sixty-two patients (37.1%) had grade I IPP, 21 patients (12.6%) had grade II IPP and 84 patients (50.3%) had grade III IPP. The mean prostate volume and peak flow rate were 64 g ± 34.7 and 11.6 ml/s ± 5.4, respectively. The median PVR was 45 ml with a range of 0–400 ml. There was a significant positive correlation between the IPP and IPSS (P = 0.001). IPP also had a significant positive correlation with prostate volume and post-void residual and a significant negative correlation with the peak flow rate (P < 0.01). Conclusion Intravesical prostatic protrusion is a reliable predictor of severity of LUTS as measured by IPSS, and it also shows good correlation with other surrogates of bladder outlet obstruction.

Peak Flow Meter with Measurement Analysis

The Peak flow meter is a device used to measure the amount of airflow in the human airway or often referred to as PFR (Peak Flow Rate). Peak Flow Rate (PFR) measurement is a simple and reliable way to detect airway obstruction. PFR measurement is a simple, non-invasive, fast and economic method to assess the strength and speed of expiration in L / min, through maximum expiration of capacity total lung. The results of peak flow data can illustrate early warning signs for an illness that in some cases may show a decrease in lung function 1-3 days before other respiratory symptoms become apparent. This module is designed using MPX5100GP sensor. This sensor has a pressure range of 0-100 Kpa. The Nature module is also equipped with data storage facilities using an SD Card so that the measurement data can be processed using Ms. Excel to find out graph data for further diagnostic purposes. The inspection results can be directly viewed on the display and also automatically stored in the SD Card storage that has been available. This module has the highest error rate of 4.41% and the lowest error value of 0.42% compared to the original device. From the data collection that has been done, it can be concluded that this module can be used for the inspection process.

Studi Kolam Retensi Sebagai Upaya Pengendalian Banjir Sungai Bruno Desa Sidomulyo Kecamatan Semen Kabupaten Kediri

Retention ponds function to fill time and can be combined with a pump or floodgates to cope with flooding. This study aims to determine the flood discharge that the Bruno River cannot accommodate. The method used is data from the research location and literature review of previous studies. Namely Hydrological Analysis of rainfall data for 10 years taken from the Kanyoran station. Until calculating the flood discharge plan with the Rational method. The Rational Method is one of the common methods used to estimate the peak flow rate. Results for a 50 year return period, get an excess of flood discharge of 64,363 m3 / s, duration of rain (t) 3.2 hours and a minimum storage volume of 378 580.32 m3 . Retention pond with dimensions plan K1 p = 300m, l = 130m, t = 2m, and K2 p = 300m, l = 125m, t = 2m. Kolam Retensi berfungsi untuk menampung air sementara waktu dan dapat dikombinasikan dengan pompa atau pintu air untuk menanggulangi banjir. Penelitian ini bertujuan untuk mengetahui debit banjir yang tidak dapat ditampung oleh sungai Bruno. Penelitian ini menggunakan Analisis Hidrologi terhadap data curah hujan selama 10 tahun yang diambil dari stasiun Kanyoran. Hingga menghitung debit banjir rencana dengan metode Rasional. Metode Rasional adalah Salah satu metode umum yang di gunakan untuk memperkirakan laju aliran puncak Hasil untuk kala ulang 50 tahun, didapatkan kelebihan debit banjir sebesar 64,363 m3/dtk, lama hujan (t) 3,2 jam dan volume tampungan minimal sebesar 378 580,32 m3 . Kolam Retensi direncanakan dengan dimensi K1 p = 300m, l = 130m, t = 2m, dan K2 p = 300m, l = 125m, t = 2m.

Urological Aspects in Patients with Alkaptonuria: A Case-Control Study

This study aimed to evaluate the urinary tract for dynamic function and stones and calcifications in patients with alkaptonuria. Thirty-eight patients were prospectively divided into two groups. Study group (A) involved 17 patients; the average age was 42 years. The control group (B) involved 21 patients; the average age was 37 years. All patients from the two groups underwent uroflowmetry assessment and ultrasonography for the kidneys and urinary bladder, and prostate in two phases (full bladder and empty bladder). Group A—Bladder volume ranged between 400 and 520 cc. The peak flow rate was between 7 and 23 mL/s, with an average of 18.6 mL/s. Flow rate curves shape were acceptable to the normal bell-shape curve in 11 patients. Seven patients (41%) had prostate calcification accounting for 5%–35% of prostate size. Group B—Bladder volume ranged between 290 and 510 cc. The peak flow rate was 8–27 ml/s, with an average of 20 mL/sec. Normal bell shape voiding curves were observed in 17 patients (80%). Four patients (19%) had prostate calcification accounting for 2%–12% of prostate size. Renal measurements on ultrasonography were the same in both groups. Patients with alkaptonuria developed prostate calcification at younger age; they have a slight but not statistically significant reduced peak urinary flow rate and post void residual urine.

Cough Expired Volume and Cough Peak Flow Rate Estimation Based on GA-BP Method

Cough is a respiratory protective behavior for clearing the secretion. The cough process can be characterized by three features which are cough peak flow rate, peak velocity time, and cough expired volume. The cough expired volume (CEV) and the cough peak flow rate (CPFR) are important for medical diagnosis and cough effectiveness assessment. In this study, the CEV and CPFR values of 700 healthy participants were measured and collected by using a portable pulmonary function device. The gender, age, height, weight, and smoking status information of the 700 participants were also collected. Meanwhile, the integration of backpropagation neural network and genetic algorithm (GA-BP) method was developed to estimate CEV and CPFR values. The results showed that the estimation accuracy of GA-BP method exceeds 90%, which indicates that the GA-BP method could be effectively used for CEV and CPFR value estimation. Furthermore, the method proposed in this paper could be useful for medical diagnosis and medical device development.