EFFECT OF MURCHHIT TILA TAILA UTTARBASTI IN MANAGEMENT OF URETHRAL STRICTURE - A CASE STUDY

In Geriatric patients, urological problems like dribbling micturition, burning micturition, dysuria etc. are commonly seen due to Urethral Stricture, BPH, Chronic urinary tract infection, Urinary Incontinence, Over-active bladder etc. In this study, we will discuss the effect of the Ayurvedic Panchkarma Procedure i.e., Uttarbasti in Urethral Stricture. Urethral Stricture involves scarring that narrows the tube that carries urine out of the body mostly due to STD’s, Catheterisation, straddle injury to the perineum. Newer Surgical Techniques like Urethral Dilatation, DVIU, Ure- throplasty etc are used but they are painful, expensive & has recurrences. In Ayurvedic literature, Mutra mar- gasankoch and Mutrotsanga are an entity that can be closely related to urethral stricture which is described by Acharya Sushruta in Uttartantra. In this case study, a 45-year-old male patient suffering from LUTS Came to Shalya OPD undergone repeated urethral dilatations but was unrelieved. So, after clinical evaluation & Investiga- tions, the case was diagnosed as Urethral Stricture & treated with Uttarbasti. In this case study, Murchhit Tila Taila for the Uttarbasti procedure was used. After the Procedure results were evaluated & the results are satisfying. Keywords: Uttarbasti, Murchhit Tila Taila, Urethral Stricture

Biomarkers in the Light of the Etiopathology of IC/BPS

In this review, we focused on putatively interesting biomarkers of interstitial cystitis/bladder pain syndrome (IC/BPS) in relation to the etiopathology of this disease. Since its etiopathology is still under discussion, the development of novel biomarkers is critical for the correct classification of the patients in order to open personalized treatment options, on the one hand, and to separate true IC/BPS from the numerous confusable diseases with comparable symptom spectra on the other hand. There is growing evidence supporting the notion that the classical or Hunner-type IC (HIC) and the non-Hunner-type IC (NHIC) are different diseases with different etiopathologies and different pathophysiology at the full-blown state. While genetic alterations indicate close relationship to allergic and autoimmune diseases, at present, the genetic origin of IC/BPS could be identified. Disturbed angiogenesis and impairment of the microvessels could be linked to altered humoral signaling cascades leading to enhanced VEGF levels which in turn could enhance leucocyte and mast cell invasion. Recurrent or chronic urinary tract infection has been speculated to promote IC/BPS. New findings show that occult virus infections occurred in most IC/BPS patients and that the urinary microbiome was altered, supporting the hypothesis of infections as major players in IC/BPS. Environmental and nutritional factors may also influence IC/BPS, at least at a late state (e.g., cigarette smoking can enhance IC/BPS symptoms). The damage of the urothelial barrier could possibly be the result of many different causality chains and mark the final state of IC/BPS, the causes of this development having been introduced years ago. We conclude that the etiopathology of IC/BPS is complex, involving regulatory mechanisms at various levels. However, using novel molecular biologic techniques promise more sophisticated analysis of this pathophysiological network, resulting in a constantly improvement of our understanding of IC/BPS and related diseases.

Assessment of the infectious factor in transurethral surgery of benign prostate hyperplasia

Performing surgical interventions for benign prostate hyperplasia against the background of chronic urinary tract infection or prostatitis can adversely affect the course of the postoperative period and mediate the development of complications. Therefore, it is important to understand the pre- and postoperative bacterial status of the patients in various endourological surgical techniques and its relationship with possible infectious complications. This review raises the problem of insufficient knowledge regarding the clinical structure of infections during transurethral surgery, assessment of their relationship with the course of the underlying pathology and the severity of symptoms.

Inverted papilloma, a Crying wolf of the urinary bladder

Inverted papilloma is a benign, non-invasive and innoxious bladder tumour rarely seen. These tumours are associated with chronic urinary tract infection, bladder neck obstruction, and they appear similar to other bladder tumours. Inverted papilloma is diagnosed on histopathological examination. We report a case of inverted papilloma who presented and appeared as bladder tumour but on subsequent pathological examination diagnosed as inverted papilloma. Keywords: Inverted papilloma; Benign; TCC (Transitional cell carcinoma); PUNLMP (Papillary urothelial neoplasm of low malignant Potential)

C3 Glomerulonephritis With Chronic Urinary Tract Infection: a Case Report and Literature Review

Background: C3 glomerulonephritis(C3GN) is one type of C3 nephropathy(C3G) which is a rare glomerular disease associated with abnormal regulation of the alternative complement pathway. This review reports a rare case of C3GN with repeated urinary tract infection and summarizes the clinical features, differential diagnosis, treatment, and outcome of patients with C3GN. Case Presentation: A 44-years-old woman was pathologially diagnosed as C3GN. We were confused with her recently upper respiratory tract infection and repeated urinary tract infection before the diagnosis is confirmed. We conducted gene testing and found C3 and CD46 gene mutations, which were related to C3G and atypical thermochemical syndrome in previous reports. After antibiotic treatment, the level of complement C3 was higher than before. We strongly suspect that the urinary tract infection are related to C3 glomerulonephritis.Conclusion: Clinical diagnosis of C3GN is difficult to make due to there are many differential diagnosis, especially post infection nephritis. This case emphasizes the importance of renal biopsy in the diagnosis of C3GN, but the relationship between gram-negative bacilli and C3GN is still unclear. In addition, gene mutation is also involved in the pathogenesis of C3GN, and the treatment of C3GN still needs to be explored.

Antimicrobial Resistance in Escherichia coli and Resistance Genes in Coliphages from a Small Animal Clinic and in a Patient Dog with Chronic Urinary Tract Infection

Antimicrobial resistance is on the rise in certain pathogens that infect pets and their owners. This has raised concerns about the use of antibiotics and the transfer of resistance elements in small animal clinics. We sampled a surgery unit, diagnostic rooms after disinfection, and a dog with chronic urinary tract infection (UTI), in a small animal clinic in Austria, and isolated/characterized phages and Escherichia (E.) coli for antimicrobial resistance, resistance genes and transduction ability. Neither the coliphages nor E. coli were isolated in the 20 samples of the surgery units and diagnostic rooms. From the urinary tract of the dog, we recovered 57 E. coli isolates and 60 coliphages. All of the E. coli isolates were determined as resistant against nalidixic acid, 47 against ampicillin, 34 against sulfonamides, and 33 against streptomycin. No isolate held resistance against tetracycline, trimethoprim, kanamycin, or chloramphenicol. Among the 60 phages, 29 tested positive for one or more resistance gene(s) by PCR, but none was able to transduce it to a laboratory strain or to an E. coli isolated from samples. Nevertheless, six phages out of 60 were able to transduce ampicillin resistance (bla gene) after being grown on a puc19 harboring E. coli strain.

Experience of surgical treatment of leukoplakia of the urinary bladder in women with chronic cystitis

28 women with leukoplakia of the bladder, clinically manifested by dysuria and pain in the bladder were observed. All patients have a history of chronic urinary tract infection. At the time of inclusion in the study there were no signs of exacerbation of cystitis. All patients underwent laser ablation of the altered bladder mucosa. Control examinations were performed 1, 3, and 6 months after surgery. Positive dynamics of clinical indicators was noted after surgery in all patients. Tolerance to laser ablation was satisfactory, there were no postoperative complications. A complete recovery of urothelium in the operation area was achieved after 6 months according to control cystoscopy. The results of the study showed high efficiency and safety of laser ablation of the altered bladder mucosa in patients with leukoplakia.

Fatigue

A systematic approach to fatigue: Figure out how bad it is; rule out the complaint of concussion-related fatigue as an excuse to get out of school, work, or unpleasant chores at home by asking the collateral source how fatigued the patient acts in everyday life; rule out depression; rule out a primary sleep disorder; rule out alcohol, sedating medications, and other drugs; rule out withdrawal from stimulants; rule out a systemic cause such as hypotension, hypoxemia, renal failure, liver failure, anemia, hyponatremia, hypothyroidism, vitamin D deficiency, and chronic urinary tract infection. If these are not present or fatigue persists after treatment, consider prescribing one or more of the following: a very gradually progressive exercise program, bright light treatment, complete alcohol cessation, a diet that is low in refined sugar, a stimulant, amantadine, and modafinil. Consider using a quantitative measure, such as The Fatigue Severity Scale.