Benign Prostatic Hyperplasia (BPH) is one of the commonest medical conditions affecting the geriatric male population. The enlargement of prostate can lead to various clinical symptoms like difficulty in voiding, urinary retention etc. The symptoms are varied depending on the size of enlargement. The International Prostatic Symptom Score (IPSS) is the gold standard and first step in understanding and diagnosing the disease clinically, but in the recent past there are various other newer tools to diagnose the prostate hyperplasia. Event in the treatment modalities, the management of BPH has grown incredibly. Both medical and surgical management would aid the patients in increasing the Quality of life and reduces the disease burden.
Pulmonary hypertension is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest as assessed by right heart catheterisation. Pulmonary hypertension in pregnancy is known to be associated with significantly high morbidity and mortality rate which ranges between 30% and 56%. So during pregnancy, efforts to be made to diagnose common medical ailments that can be complicated by pulmonary hypertension. Bedside 2D Echo and thoracic ultrasound are the strongly recommended in these patients to diagnose early and prevent the devastating complications. Relevant blood investigations need to be sent to diagnose the underlying etiology and to assess the prognosis. Cardiac catheterization is the gold standard investigation of choice for pulmonary hypertension. But it is 1 performed in very few cardiac centres in developing countries. In India diagnosis largely depends on echocardiography. It should be made clear to women at the time of their PAH diagnosis that pregnancy is not recommended due to the high maternal and fetal risks. If a woman with known PHT become pregnant, counselling should be given for therapeutic abortion. If they are willing for therapeutic abortion, it should be done before 22 weeks of gestation. All women with PHT should be initiated on PAH specific therapies (prostanoids, ccbs, phosphodiesterase inhibitors) except endothelin receptor blockers as it is teratogenic. Pregnancy in PAH is difficult to manage and needs mutidisciplanary team. Pregnancy is not recommended in women with PAH and appropriate counselling to be done to the mother and their relatives.
Background: To evaluate the efficacy and safety profile of alpha-1A receptor subtype specific antagonist-tamsulosin in benign prostatic hyperplasia.Methods: An open label, non-randomised, prospective, single centred study who were visiting urology department with confirmed diagnosis of benign prostatic hyperplasia (BPH) were included in the study. Thirty patients with BPH were prescribed tamsulosin and were followed up to three months. The initial or baseline data collected were identification of the patients such as international prostate symptom score (IPSS), prostate specific antigen, urine analysis, and ultrasonography of prostate including post void residual urine. The patients were followed up to 3 months to measure clinical and laboratory outcomes (IPSS score, post void residual urine, uroflow rates etc.).Results: In our study, patients receiving tamsulosin 0.4 mg once daily showed a significant improvement in post-void residual urine (PVRU), uroflow rates and IPSS score. The improvements in the above parameters were found to be statistically insignificant at first and third month of follow-up.Conclusions: In our study, tamsulosin an alpha-1A receptor subtype specific antagonist showed significant improvement in BPH symptoms and the drug was well tolerated.
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