Abstract:Uncontrolled painless day time micturition is a serious social problem. Till date, there has been no report in literature of day time uncontrolled micturition in adult patient subsequent to therapy with valproic acid. A young adult male patient with idiopathic generalized tonic clonic seizures was started on valproate but continued to have breakthrough convulsions despite administration of valproate 300 mg twice a day. The dose of valproate was increased to 900 mg per day which controlled seizures but he developed uncontrolled painless passage of urine even during daytime while remaining conscious and alert. Detailed physical examination and investigations did not reveal any abnormality. Keeping in mind, the rare association of valproate with nocturnal enuresis, dose of valproate was decreased to 600 mg leading to abolition of day time enuresis. Unfortunately, convulsive movements returned. The dose of valproate was increased gradually over a period of two weeks to 900 mg per day. Once again, urinary incontinence recurred. Gradual switching over from valproate to carbamazepine controlled his seizures and stopped day time enuresis. In conclusion, this case report highlights the need to keep valproic acid in mind during differential diagnosis of uncontrolled painless day time micturition if this drug is being used in therapy.

BackgroundBurn injuries are highly variable and dynamic. The outcome of patients is influenced by various factors and requires prompt therapeutic interventions, including fluid resuscitation, for a favorable result. Although having varying shortcomings, many scoring indexes are developed and validated in Western countries to predict mortality in a burn patient. The Abbreviated Burn Severity Index (ABSI) estimates survival expectancy in a burn patient via various negative prognostic factors. This study describes the pattern of burn injuries to validate the ABSI as an outcome predictor in burnt patients. MethodologyFrom January to December 2018, 100 patients participated in this observational research conducted in the Department of Surgery at Mahatma Gandhi Hospital's Burn Ward, a part of Dr. Sampurnanand Medical College, Jodhpur. Risk factors for death from a burn were patients' age and gender, the depth of the burn, the inhalation burn, and the total burned body surface area (TBSA). The area under the receiver operating curve (AUROC) was used to determine how well it could predict burn deaths. ResultsThis study included 100 patients (69 men and 31 women, with a ratio of 2.22:1). In total, 73 patients survived, and 27 died (a mortality rate of 27%). The fatality rate increased with increased burn surface area, reaching 100% in patients with >80% burns (p < 0.0001). Additionally, those with an ABSI of >11 expressed 100% mortality rate (p < 0.0001). ConclusionsIn this study, older age, high burned surface area, concomitant inhalational burns, full-thickness burns, and a higher ABSI were found to be significant predictors of mortality.

Background and objectiveSince early 2020, the novel coronavirus disease 2019 (COVID-19) has turned into a global healthcare concern. The usual clinical presentation of COVID-19 infection includes myalgia, headache associated with pyrexia, and sore throat. Our study aimed to assess the severity of lower urinary tract symptoms (LUTS) in COVID-19 patients and determine its correlation with the prognosis of the disease. MethodsWe conducted an observational study in the COVID-19 care unit at a tertiary care teaching center in Rajasthan on patients diagnosed as COVID-19-positive. The overactive bladder (OAB) symptom scoring system for LUTS and the CT scoring system for lung involvement in COVID-19 patients were used to evaluate the sample population. ResultsWhile our findings showed a non-significant association between OAB and CT score (p>0.05), correlation analysis revealed that the length of hospital stay was significantly longer and oxygen needs were significantly more frequent with severe LUTS. ConclusionsBased on our findings, de novo LUTS, particularly storage symptoms, may be present in COVID-19-positive cases, and the severity of these symptoms may have an impact on the patient's length of stay in the hospital. Hence, doctors and other medical professionals should consider COVID-19-related bladder dysfunctions such as de novo LUTS as part of COVID-19 symptomatology.

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