The study compares the role of suprapubic cystostomy versus per urethral catheterization in BPH patients with acute retention of urine. Majority 80% patients were 50-70 years old. The higher number of patients in Group A (18/25) voided normally with good flow rate of almost 15ml/sec and non-significant residual urine, compared to Group B (13/25). In Group B, 12 patients required re- catheterization while only 7 in Group A needed to have their suprapubic catheter opened. All patients took Tamsulosin 0.4mg daily. Patients in Group A had their suprapubic catheter clamped and tested for voiding through the urethra; while Group B was tested without a catheter. The flow rate and PMRV noted. In group A, 7 patients had retention relieved by a suprapubic catheter. Two patients pulled out per urethral catheterization and was excluded from the study. The results showed the effectiveness of suprapubic cystostomy for benign prostatic hyperplasia patients with first-time urine retention.
Objective: To determine the outcomes of intraplaque verapamil injection for treatment of Peyronie's disease. Aim:The purpose of this study is to evaluate the outcomes & efficacy of intraplaque verapamil injection in Peyronie’s disease management. Methods: The quasi experimental study was conducted from July 2018 to July 2019 on a group of 26 subjects suffering from Peyronie's disease. After detailed history, complete physical and genital examination, the diagnosis was confirmed. After informed consent, questionnaires regarding pain and sexual satisfaction of patients were filled. All patients received verapamil injections on weekly basis for a period of 10 weeks. After that, all necessary variables were recorded and data analyzed using SPSS version 16. Results: Most of the patients in our study were in the age group of 30-65 years. 26.9 % patients were in the range of 51-55 years old. 53.8% patients got no effect of intralesional injection of verapamil on pain while pain relieved in 38.5% of patients & 7.7% patients experienced an increased in pain intensity after 10 weeks of intralesional injection of verapamil. 61.5%of patients satisfied with their sexual life after 10 week of injections & 30.8% of patients remained unsatisfied with their sexual life while in 7.7%of patients symptoms aggravated. 53.8% of patients experienced no change in size of lesion and curvature of penis, while 30.8% got less than 50% reduction in size of lesion while 15.4% of patients got more than 50% reduction in size after 10 weeks. Practical implication: We can easily find the efficacy of Verapamil injection for management of Peyronie’s disease. Conclusion: This study concluded the efficacy of Verapamil injection for management of Peyronie’s disease disease causes significant decrease in size of lesion and improvement in sexual activity. Keywords: Peyronie’s disease, Improvement, Lesions, Significant
Objectives: The objective of this study was to determine the predictive value of GRACE score for predicting obstructive coronary artery disease in patients with non ST-segment elevation myocardial infarction (NSTEMI). Methodology: This cross-sectional study was conducted at the largest public sector cardiac care center of the Pakistan between January 2020 and June 2020. In this study, we included adult patients diagnosed with NSTEMI and correlation of GRACE score was assessed with angiographic finding of obstructive CAD defined as ≥50% stenosis in the left main or ≥70% stenosis in other coronary arteries. Results: A total of 227 patients were included in this study, out of whom 72.2% (164) were male patients and mean age was 55.77 ± 9.15 years. Mean GRACE score was found to be 95.89 ± 21.15. On coronary angiography obstructive CAD was present in 84.6% (192) of the patients. Area under the cure for predicting obstructive CAD was 0.669 [0.552 to 0.785]. The optimal cutoff value of GRACE score was ≥ 84 with sensitivity of 79.7% [73.3% to 85.1%] and specificity of 57.1% [39.3% to 73.7%]. GRACE score of ≥ 84 was found to be an independent predictor of obstructive CAD with odds ratio of 4.33 [1.61 - 11.64; p=0.004] adjusted for gender, age, hypertension, diabetes, family history of CAD, and smoking. Conclusion: GRACE score has a moderate predictive value in predicting obstructive CAD in patients with NSTEMI. The optimal cutoff value of 84 is an independent predictor with good sensitivity but moderate specificity in predicting obstructive CAD.
Aim: To compare the incidence of in-hospital complications between diabetic normotensive and hypertensive diabetic patients presenting with acute myocardial infarction (MI) Methodology: This observational cohort study was conducted at National Institute of Cardiovascular Diseases Karachi from May 2019 to April 2020. We examined 220 diabetics with acute MI were included. 50% of the patients had high blood pressure and the rest had normal blood pressure. After enrollment in the study, selectees were observed for acute myocardial infarction complications in the hospital. Results: Most of the baseline characteristics were similar in both groups of patients. However, the hypertensive patients in the diabetes group had diabetes, high heart rate, and high blood pressure at reporting. The complication rates did not differ statistically between the two groups. The rates of complications occurred between diabetes and normotensive hypertension; Atrial fibrillation (AF) 15.5% vs 12.7% p = 0.194, respectively, ventricular tachycardia (LH) 14.5% vs 13.6%, AV block type-1 8.2% vs 7.3% p = 0.296, type2 AV block 2.7% vs 1.8% p = 0.352, complete heart block 11.8% vs 10% p = 0.313, acute congestive heart failure (CHF) 13.6% VS% 9.1 p = 0.137, left ventricular failure (LVF)19.1% vs 16.4% p = 0.259, cardiogenic shock (CS) 14.5% vs 10.9% p = 0.184, recurrent IM (Re-MI) 14.5% 10.9% p = 0.184 and mortality 14.5% vs 12.7 and% p = 0.326, respectively. Conclusion:It is concluded that diabetic patients with hypertensionhave not elevated risk of complications in the hospital after acute myocardial infarction. Key words: diabetes, hypertension, hospital complications, acute myocardial infarction
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