Objective: To assess the clinical, urodynamic efficacy, and safety of mirabegron in patients with neurogenic detrusor overactivity (NDO) consequent to traumatic spinal cord injury (SCI). Methods: This prospective cohort study was performed between January 2018 and July 2019 and included adult patients with stable traumatic suprasacral SCI, performing clean intermittent catheterization (CIC), and demonstrating NDO on urodynamic study (UDS). A 3-day bladder diary was made at the baseline after which all patients were started on Mirabegron 50 mg. They were followed up at 6 weeks with a repeat bladder diary and UDS which were compared with those at the baseline. Results: A total of 30 patients (4 females, 26 males, mean age: 30.07 years) were included. After 6 weeks of treatment, 5 out of the 29 incontinent patients became completely dry. The mean frequency of CIC decreased from 6.63 at the baseline to 5.37 at 6 weeks (p = .002), the mean CIC volume increased from 275 ml to 341 ml (p = .0002), the mean number of incontinence episodes in between CIC reduced from 3.97 to 2.27 (p < .0001) and time from CIC to leakage increased from 1.73 h to 2.75 h (p < .0001). The mean cystometric capacity increased from 348 ml to 406 ml (p = .008) and the maximum amplitude of NDO decreased from 54 cm H 2 O to 41 cm H 2 O (p = .005) at 6 weeks. Only two patients reported new onset dry mouth. No major adverse events were noted and none discontinued treatment. Conclusion: Mirabegron is efficacious and safe in patients with NDO consequent to traumatic SCI.

Aims: To assess the efficacy and safety of autologous mid-urethral sling (MUS) in women with predominant stress urinary incontinence (SUI). Materials and Methods: This prospective cohort study included adult women with predominant SUI seen in our urology clinic between January 2018 and March 2019. Patients with: negative cough stress test, history of prior incontinence surgery, urogenital malignancy, pelvic radiation, neurological disease, body mass index more than 40 kg/m 2 , the presence of more than Stage I pelvic organ prolapse, active urinary tract infection, maximum flow rate less than 15 ml/sec, postvoid residual urine more than 100 ml, abdominal leak point pressure less than 60 cm of H 2 O, and pregnant women were excluded. Eligible patients underwent a transobturator MUS procedure using rectus fascia as a sling. Before the procedure, patients filled the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS) and the Female Sexual Function Index (FSFI) questionnaire. Urinary outcomes were assessed at 3-and 12-months while sexual outcomes were assessed at 12-months. Results: Thirty patients with median age of 44.5 years were included. All patients had a negative cough stress test during follow up. A significant improvement was noted in the ICIQ-FLUTS scale, bother scale, filling and incontinence subscales at 3 and 12 month follow-up. A significant improvement was also noted in the FSFI full scale score and FSFI domains of mean sexual desire, arousal and lubrication at 12 months follow-up. Two patients developed voiding dysfunction requiring urethral dilatation. Conclusion: Autologous transobturator MUS surgery appears to be safe and efficacious in the short term. More research is needed to clarify its role in the surgical management of SUI in women.

Background:This prospective study was carried out to compare outcome and postoperative complication in patients with gastro-intestinal malignancy who received preoperative total parentral nutrition with those whom doesn’t.Methods: The study was a prospective single-centre, two-arm, conducted in department of general surgery, Gandhi Medical College and Associated Hamidia Hospital, Bhopal, Madhya Pradesh, India of one year duration, a total of 60 patients with G. I. malignancy, with or without sign of malnutrition, were included in the study. Patients were randomized and 30 patients were placed in each arm (interventional and control group) patients in the control group were asked to continue their normal feeding while interventional arm were given TPN in addition to their normal diet, for 7 to 10 days before surgery.Results:Infectious complications were more in control group, while one case each of pneumonia and sepsis was observed in patients receiving supplementation. Complications related to nutritional status of the patient like wound infection and anastomotic leak were observed only in patients without supplementation. There was no death observed in interventional group but two deaths occurred in control group.Conclusions:Preoperative nutritional support is beneficial and should be routinely used in abdominal and gastrointestinal cancer patient with or without clinical signs of malnutrition.

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