INTRODUCTIONProstate is one of the accessory glands of the male reproductive system that secretes fluid to form bulk of the semen along with the seminal vesicles and bulbo urethral glands. In post pubescent male, the prostate gland has a volume of upto 20 to 30 ml. The prostate gland comprises of apex, base with an anterior, median, posterior and two lateral lobes. Zones of the prostate gland according to McNeal, are divided into: a) Peripheral zone (70%) of the gland, which are more prone for prostatic cancer; b) Central zone (20%) of the gland, is posterior to the lumen, and above the ejaculatory ducts; c) Peri urethral transition zone (10%), most common for BPH. Structural zone of prostate is composed of concentric zones separated by an ill-defined irregular capsule. The inner zone of prostate gland near the urethra is composed of submucosal glands that open directly into prostatic sinuses which are more prone for BPH. The outer zone has large branched glands and is more prone for prostatic cancer [1]. In men above 40 years of age, BPH is a common entity with significant disability. It is a condition that occurs when the enlarged prostate gland compresses the urethra leading to BOO. BPH can be a histological diagnosis that refers to proliferation of smooth muscle, fibrous tissue and glandular tissue within the prostatic transition zone. The clinical assessment of prostatic size by trans abdominal sonogram has proven to be a more accurate predictor of actual prostatic size, as studies show that trans-abdominal sonogram estimate of prostate size and surgical size shows good correlation [2]. The enlarged gland contributes to the lower urinary tract symptoms through two routes by direct BOO from enlarged tissue (static component) and by increased smooth muscle tone and resistance (dynamic component). The over activity of detrusor is thought to be a contributor to the storage symptoms seen in lower urinary tract symptoms. The symptoms of lower urinary tract caused secondary to BPH are usually not life threatening but can impact the quality of life and should not be underestimated [3]. Urine flowmetry is the electronic recording of urine flow rate throughout the micturation. Abnormal urine flow may be caused by BOO and bladder dysfunction resulting in significant PVR volume. Increasing PVR urine volume denotes significant bladder dysfunction and risk of developing urinary tract infection. Thus, this concept favours inclusion of PVR urine volume measurement in the evaluation of men with BPH [4]. Thus men with lower urinary tract symptoms based on International prostatic symptoms scale, suggestive of BPH should undergo clinical evaluation for prostatic size by trans-abdominal sonogram. They should further be evaluated by urine flowmetry for PVR urine to assess the severity of BOO. Complication of BPH includes bladder calculi, renal failure, infection, incontinence, retention, haematuria [5]. So the purpose of this study was to assess the size of the prostate gland in patients with lower urinary tract symptoms and to ...

The COVID-19 pandemic is being a global Heath crisis. The rate of transmission of the disease is very high. At this time there is no specific vaccine or treatment. This widespread outbreak is also associated with psychological distress like depression and anxiety. The effect of COVID 19 on medical students is considerable. The medical students are in a transitory period which could be one of the most stressful times in a person’s life. The aim of this study is to assess the mental health of South Indian medical students during the COVID-19 pandemic and to see if there is any influence of gender on mental health. A cross sectional study was conducted using convenient sampling method. A total of 359 responses were analysed. Anxiety and depression symptoms were assessed based on four point Likert scale. GAD-7 (General Anxiety Disorder-7) scale and CES-D (Center for Epidemiology Studies for Depression) scale is used to assess anxiety and depression symptoms with a small modification respectively. Data analysis was performed using IBM SPSS statistics version 25. Out of 359 participants 50.4% of participants were male and 49.6% of them were females; majority of them (95.3%) were between the age group of 18-21. In total 75.5% and 74.6% of participants showed varying levels of anxiety and depression symptoms respectively. Anxiety and depression symptoms are found to have a mild association with gender. Symptoms are slightly higher among females than males.

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The variations in blood vessels are common and have long received the attention of anatomists and surgeons. The true pelvic cavity usually refers to that part of pelvis, which has its bony walls, the sacrum and lower part of hip bone. This small area is well covered by bones and has important structures namely the pelvic viscera, pelvic floor muscles, vessels and nerves supplying it. The aim of the study was to know the branching pattern of internal iliac artery based on the Adachis classification, along with length and thickness of artery. The internal iliac artery was traced from its origin, course, branching pattern, length and thickness of the trunk of internal iliac artery was measured by using digital vernier calliper from its point of origin to bifurcation into anterior and posterior division. The length of right & left internal iliac artery ranged from 2.4 cm to 5.4 cm with average length of 3.943cm ± 0.859cm, whereas the length of left internal iliac artery ranged from 2.7cm to 4.7cm with average length of 3.610cm ± 0.626cm. Bilateral ligation of internal iliac artery is helpful in controlling postpartum haemorrhage. Applying ligatures on an anomalous blood vessel may lead to alarming haemorrhage. The most ideal point of ligation of internal iliac artery would be distal to its posterior division, since proximal ligation has been associated with buttock claudication and necrosis. Knowledge regarding the internal iliac artery and its branches is helpful in applying ligatures safely during pelvic surgeries.