Benign prostatic hyperplasia (BPH) is an age-related phenomenon associated with prostatic enlargement and bladder outlet obstruction that can cause significant lower urinary tract symptoms (LUTS). These LUTS have a negative impact on an individual's quality of life, which is why treatment of symptomatic BPH has become a major priority. Although surgical interventions exist for treating BPH, pharmacological therapies are often preferred due to their minimal invasiveness and high degree of effectiveness. The three classes of drugs approved for treating BPH include α-blockers, 5-α-reductase inhibitors (5-ARIs) and phosphodiesterase 5 (PDE-5) inhibitors. Individually, each class of drug has been studied and shown to improve symptom relief through a variety of different mechanisms. A more recent focus has been on the development of combinatorial therapies that combine classes of drugs in order to provide maximal benefit. The mTOPS and CombAT studies were the first of their kind to examine whether the combination of 5-ARIs and α-blockers was more effective than monotherapy alone. Both studies found similar results in that the combinatorial therapy was superior to monotherapy. Over the last decade other combinatorial therapies have been at the forefront of investigation. One in particular is the combination of tadalafil, a PDE-5 inhibitor, with finasteride, a 5-ARI. Studies have shown that the combination of tadalafil and finasteride is a safe, effective, and well tolerated treatment for BPH. Evidence suggests that this combination may be particularly effective in reducing treatment-related sexual adverse events associated with 5-ARI treatments. The following review will explore in detail the current evidence surrounding treatment of BPH LUTS using tadalafil and finasteride.

Background: Multiple animal antigens, spores and pollens were collected and identified from the Kuwaiti atmosphere. The role for these antigens in mediating allergic rhinitis for Kuwaiti residents needs to be evaluated. Objective: To investigate the causes (both indoors and outdoors) of allergic rhinitis for Kuwaiti residents. Method: This is a retrospective study of all positive skin tests that we obtained in our Allergy clinic in Mubarak Alkabeer Hospital in Kuwait, during the period between May 2013 and December 2015, from patients who presented with allergic rhinitis symptoms and/or signs. They underwent skin prick tests to a battery of common allergens (german cockroach, cat dander, dog dander, house dustmites mix, cladosporium, aspergillus mix, penicillium mix, alternaria, grass pollens mix, Russian thistle pollens, mugwort pollens, rough pigweed pollens, sorrel pollens, compositae pollens, olive pollens, and date palm pollens). A wheal of ≥3 mm was considered a positive skin test. Results: A total of 177 patients with rhinitis (90 females and 87 males) had positive test results to at least one allergen and were considered allergic. 77.9% of the patients had positive results to Russian thistle pollens, 39.9% to cat dander, 29.9% to grass pollens mix, 22.6% to compositae pollens, 22.6% to mugwort pollens, 22% to house dust mites mix, 21.4% to olive pollens, 20.9% to German cockroach, 20.3% to dog dander, 18.1% to rough pigweed pollens, 15.8% to date palm pollens, and 12.4% to sorrel pollens, 14.7% to penicillium, 10.7% to cladosporium, 10.7% to aspergillus mix, and 4% to alternaria. Conclusion: Russian Thistle pollen is the commonest sensitization for Kuwaiti residents with allergic rhinitis. Background: Environmental allergies affect many individuals of all ages. There are several aeroallergens that can trigger allergic reactions, namely allergic rhinitis and allergic asthma. In this study, we aimed to determine the prevalence of various environmental allergies in the Kingston, Ontario region. Methods: A chart review of skin prick test (SPT) results was completed on all patients in the practice of an academic Allergist affiliated with Queen's University. Patients who demonstrated positive SPT (defined as ≥3 mm than the negative control) to one or more allergens were included, and their age, gender and specific positive tests were recorded. Allergens evaluated included dust mites (D. pteronyssinus and D. farinae), dog dander, cat epithelium, tree mixes, birch pollen, other trees, grass mixes, ragweed mixes, short ragweed, other weeds, cockroach and numerous moulds. Of all patients reviewed, 1161 had positive SPT results to one or more allergens. Data analysis was completed with SPSS. Results: Dust mite was the most prevalent allergen (62.6%). The second and third most common were ragweed (52.6%) and cats (51.6%), respectively. The prevalence of other allergens, in order of decreasing frequency, were grass (49.7%), trees (43.1%), birch (34.8%), short ragweed (30.8%), molds (29.7%), other trees (25.6%), dog (...