Introduction: Internal urethrotomy is recommended for the treatment of urethral strictures shorter than 1.5 cm but has been associated with high recurrence rates. The aim of this study was to evaluate the efficacy of use of triamcinolone ointment for clean intermittent self catheterization in the prevention of urethral stricture recurrence after internal urethrotomy.
Methods: Total of 60 male patients undergoing internal urethrotomy were assigned into two groups and clean intermittent self catheterization was performed using either triamcinolone ointment or a water-based gel for lubrication of the catheter in this randomized clinical trial. Clean intermittent self catheterization regimen was continued for 6 months and patients were followed for 12 months. Urethrocystoscopic evaluation was done 6 and 12 months postoperatively.
Results: The recurrence rates were compared between the two groups. There were no significant differences in patient characteristics and etiology of the stricture between the two groups. There was a 6 (22.22%) recurrence rate in the patients of the triamcinolone group against 13 (46.42%) in those of the control group after the first internal urethrotomy (P=0.04). After second internal urethrotomy, the urethra was stabilized in 5 (83.3%) of the patients in the triamcinolone group and 8 (61.5%) those in the control group (P=0.05). We also found a significant correlation between recurrence and stricture length (P=0.02) but the time to recurrence was not statistically significant (P=0.16).
Conclusions: The use of triamcinolone ointment in patients on CISC regimen after internal urethrotomy significantly decreased the stricture recurrence rate.
| Fascioliasis is a widely distributed and economically important parasitic disease of ruminants. A cross sectional opportunistic survey was conducted using qualitative and quantitative faecal examination techniques to determine the prevalence of fascioliasis in household's cattle, buffalo and goat in Nepal. Animals were sampled from households, in Mahottari and Dhanusha districts during July, 2014. The overall prevalence of fascioliasis was 51% in cattle, 86% in buffalo and 47% in goat, respectively. Faecal samples from Mahottari district had shown a significantly higher prevalence [cattle (70.59%), buffalo (58.82%) and goat (68.09%)] of Fasciola spp., egg than in Dhanusha [cattle (29.41%), buffalo (41.18%) and goat (31.91%)]. The mean egg count per gram of faeces was found 66 (CI: 51.6-80.4), 118 (CI: 97. 4-138.6) and 54 (CI: 41.3-66.7) in cattle, buffalo and goat, respectively. Variation in prevalence was also significant in relation to age and body condition score (BCS) of the animals. So, it is concluded that fascioliasis in ruminants are prevalent in Nepal. Therefore, it is essential to study detailed epidemiology of fascioliasis and to find out effective control strategies against it.
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Most cases are asymptomatic and when symptomatic, preoperative diagnosis of MD is poor. Intestinal obstruction, Malena or hematochezia, and inflammation are major symptoms. We report three cases of 18‐month, 2‐year, and 9‐year old male patients presenting with intestinal obstruction.
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