Abstract- Asymptomatic or clinically silent kidney stones are possibly serious because, in their expected passage, they may cause infection, obstruction and renal impairment. The purpose of this study was to determine the prevalence of silent kidney stones in a sample of Baghdad population and consider how this value could affect the justification for a screening system. To our best knowledge, this is the first study of its kind conducted in Iraq. We investigated 714 consecutive patients who sustained an abdominal ultrasound at our hospital with further kidney screening. All these patients did not have clinical signs and symptoms of nephrolithiasis. Age, sex, the indication for ultrasound, the size, side, and the number of the discovered stones were recorded. We observed silent kidney stones in 3.4% of patients. Males were stone carriers mostly. Stones were detected more in the left kidney than the right. Distinctly, multiple stones and stones of a large size were minimally seen. We conclude that the prevalence of clinically silent nephrolithiasis of 3.4% does not support a global screening. Yet, this screening may be justified in a limited pattern for those male subjects higher than 50 years, having a positive family history of renal stones, and their socioeconomic status is granted.
BACKGROUND: Sacral nerve stimulation (SNS) approved for use in North America since 1997 despite the fact that the concept of using SNS to treat patients with voiding dysfunction discussed first almost 50 years ago. AIM: The objectives of the study were to assess the effectiveness of SNS the short and long term for patients with overactive bladder (OAB) dysfunction and its relation to age, gender, and causes. PATIENTS AND METHODS: This is a clinical prospective study that involved 50 cases (32 females and 18 males) with OAB. It was carried out at Ibn Sina Hospital, and the neurosciences hospital in Baghdad/Iraq from April 2015 to April 2018. All the patients were assessed preoperatively and certain inclusion criteria were used. The patients went through the 2 stage implantations of the Medtronic InterStim®. The patients were assessed at 6 months (short term) and 2 years (long term) postoperatively. RESULTS: The results of our patients were analyzed with respect to age, gender, causes of OAB, and post-operative complications. We found that younger age patients, female patients, and patients with neurogenic causes of OAB showed a better response in both the short- and long-term follow-up. CONCLUSION: Considerable progress has been made in the surgical management of OAB. Proper selection of patients is the key to the success of SNS, and female patients have better results compared to male patients. Furthermore, younger patients and patients with neurogenic causes did better than older patients and patients with idiopathic causes. SNS is a safe minimally invasive surgery with a low complication rate, and the 2 stages procedure has better results than the percutaneous nerve evaluation.
AIM:To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients.METHODS:From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded.RESULTS:Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in 7 (7.3%) patients. All cases were managed surgically. Exploration of the retroperitoneal space was done in 72 cases. Thirty-three patients died, and the overall death rate was 34.4%.CONCLUSION:Surgical exploration should be done in RPH caused by penetrating injury, but the need for urgent exploration in blunt injury is not so high, and it depends on the anatomical site of hematoma, concomitant organ injury and the hemodynamic status of patients.
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is common, yet no curative treatment identified. Cinnamon is a herbal substance, which has many applications in medicine. AIM: The aim of the study was to study the effect of cinnamon on patients with chronic pelvic pain syndrome. METHODS: Sixty patients with documented CP/CPPS randomized into two groups during 2018 and 2019 in Baghdad. The first group received 60 capsules each contained 1 g of cinnamon. The other group received 60 capsules each contained 1 g of sugar powder (placebo). All the patients instructed to take one capsule twice daily for 1 month. National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was reported for both groups at baseline and after 1 month of treatment. The primary outcome was a patient perceivable improvement defined as a reduction of the NIH-CPSI by 6 or more points after 1 month, whereas improvement of sub-scores of NIH-CPSI (pain, urinary symptoms, and quality of life) considered as a secondary outcome, and adverse reactions reported. RESULTS: Thirteen patients (43.3%) of the cinnamon group have 6 or more points of reduction in the total NIH-CPSI compared to four patients (13.3%) of the control groups (p = 0.01). The improvement in total NIH-CPSI score was mainly due to improvement in pain sub-score, whereas in urinary symptoms, there was marginal change with no significant change in the quality of life score. The only reported side effect was gastric upset in one patient. CONCLUSION: The study concluded that cinnamon improves NIH-CPSI in patients with CP/CPPS. REGISTRATION: The study was registered on ClinicalTrials.gov with the ID: NCT03946163.
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