Introduction. Urolithiasis is one of the common disorder with which about 1/5th is found in the ureter, of which 2/3rd is seen in the lower ureter. Medical expulsive therapy is one of the routine modalities of treatment which uses various drugs acting on the ureter smooth muscle by different mechanism. We aim to compare the efficacy of combination vs. single drug. Methods. This randomized controlled trial was done in 176 consecutive patients over a period of six months (March 2019 to August 2019) in Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching. Participants were divided into two groups (Group A, tamsulosin plus tadalafil, and Group B, tamsulosin) from computer-generated random numbers. Therapy was continued for a maximum of 3 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic and emergency room visits for pain, early intervention, and adverse effects of drugs were recorded. Results. Among 176 patients who were enrolled in study, 7 were lost to follow-up, and 5 people required immediate intervention. There was a significant higher stone passage rate in group A than group B (64 vs. 50; P=0.025) and shorter expulsion time (1.66 vs. 2.32 weeks P=0.001) and less number of emergency room visits and colic episodes. No significant side effects were noted during study. Conclusion. Tamsulosin plus Tadalafil is more effective than tamsulosin with early passage of stone and decreased number of colic episodes and emergency visits without significant side effects for lower ureteric calculi of 5 mm to 10 mm.
Introduction: Benign prostatic Hyperplasia is a common disorder and cause of morbidity in the ageing men. The evaluation symptoms and the bother associated with it are important for management. International Prostate Symptom Score (IPSS), Quality of life (QOL) and Benign Prostatic Hyperplasia Impact Index (BII) are practiced to quantify the severity of the disease. The size of prostate gland does not correlate with lower urinary tract symptoms. Correlation among above scoring is also not clear. Aim of the study is to evaluate correlation of prostate volume with International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index and prostate size.Methods: Prospective study. Ninety-eight patients were included. Patients were assessed preoperatively with the International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index and prostate volumes by trans abdominal ultrasound.Results: The mean age was 66.7 ± 7.3 years (50- 84) the mean IPSS, QOL, BII and prostate volumes were 23.6 ±6.0, 5.1 ± 0.9, 7.1±2.4 and 47.5±16.63 respectively. There was positive correlation between the IPSS and BII, IPSS and QOL and BII and QOL (rs= 0.89, 0.585 and 0.530 respectively) and no correlation between IPSS and BII with prostatic weight. (rs= -0.04 and -0.07 respectively).Conclusion: Management of the benign prostate hyperplasia should be considered on the bother symptoms and not on the size of the prostate.Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 6-10
Highlights
Atrial fibrillation is associated with peripheral embolism.
Renal artery embolism is reported in rare instances.
Clinical suspicion in high risk patient and urgent treatment is key to success.
Renal metastasis from osteosarcoma is a rare entity, and tumour thrombus is even rarer. To date, only 15 cases of osteosarcoma with tumour thrombus have been reported in the literature. We present a case of an 18-year-old female diagnosed as having right distal femur osteosarcoma, later presenting with renal osteosarcoma with IVC thrombus.
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