-
Evaluation of Erectile Function and Quality of Life in Patients Undergoing Methadone Maintenance Treatment
Sava Petrov,
Maria Orbetzova,
Yanko Iliev,
Doychin Boyadzhiev,
Lyuba Hadzhiyska,
Stefan Popov
Issue:
Volume 6, Issue 5, September 2017
Pages:
68-73
Received:
26 January 2017
Accepted:
10 February 2017
Published:
18 October 2017
Abstract: The controversial data for erectile function and quality of life of patients undergoing methadone maintenance treatment (MMT) and lack of questionnaire-based studies, providing information about these bio-psycho-social issues, in Bulgaria motivated the investigators to examine the frequency of erectile dysfunction among patients on methadone maintenance treatment, and to identify quality of life among these subjects. For these needs cross-sectional, observational with no intervention, case-control, questionnaire-based study was performed which included participants from 18 to 40 years of age undergoing MMT for at least six months and clinically healthy people. A total of 91 patients from 5 clinical programs for MMT in Bulgaria took part in the study and 27 clinically healthy people from the same age and without a history of drug abuse, psychiatric and somatic diseases which served as a control group. All participants signed informed consent. For evaluating erectile function International Index of Erectile Function survey was used. SF 36 v.2 quality of life survey was used for assessing the quality of the participants. When comparing results of the quality of life survey in Patient and Control group significant differences were found in all of the components of the survey (p<0.05) with lower results in the Patient group. When analysing results from the IIEF survey significantly lower total scores were present for all components of the survey in the patient as compared to the group of healthy men (p<0.05).
Abstract: The controversial data for erectile function and quality of life of patients undergoing methadone maintenance treatment (MMT) and lack of questionnaire-based studies, providing information about these bio-psycho-social issues, in Bulgaria motivated the investigators to examine the frequency of erectile dysfunction among patients on methadone mainte...
Show More
-
Urodynamic Patterns of the Idiopathic Overactive Bladder
Yuriy M. Dekhtiar,
Fedir I. Kostyev,
Oleksandr V. Rudenko,
Dmytro O. Kuznietsov
Issue:
Volume 6, Issue 5, September 2017
Pages:
74-79
Received:
16 August 2017
Accepted:
4 September 2017
Published:
19 October 2017
Abstract: The aim of study was the investigation of frequency and clinical significance of selected stereotypical recurring urodynamic patterns, which are manifested by the results of a complex urodynamic study in patients with idiopathic overactive bladder. The combined urodynamic study (CUS) was conducted in 137 patients with IOAB. The standard cystotonometry allowed to observe the maximum cystometric capacity. It also allowed to determine the bladder sensitivity (BS) and detect the presence of detrusor overactivity (DO). The results of retrograde cystotonometry established three variants of detrusor overactivity: phase DO, terminal DO, and stress-induced DO. The study of the bladder function using methods of UFM and EMG of anal sphincter in the emptying phase, confirmed the association of obstructive urination with incomplete discharge of the urethra from the effects of the sphincter. The coordination of function of the detrusor and external sphincter were assessed according to the results of CUS and sphincteric EMG. The EMG analysis in Work / Rest Assessment mode allowed to reveal the characteristic changes in the biopotential indices of the pelvic sphincter and indicated their correlation with the clinical features of the disease course. The imperative character of urination was established in 137 patients with IOAB during CUS characterized by hyperactivity and hypertensity of bladder, depending on the severity of the violation of the integrative function of LUT.
Abstract: The aim of study was the investigation of frequency and clinical significance of selected stereotypical recurring urodynamic patterns, which are manifested by the results of a complex urodynamic study in patients with idiopathic overactive bladder. The combined urodynamic study (CUS) was conducted in 137 patients with IOAB. The standard cystotonome...
Show More
-
Unusual Case of Priapism in Emergency Department of Tertiary Care Hospital of Eastern Nepal
Ritesh Chaudhary,
Bijendra Kumar Rai,
Rabin Bhandari,
Ajay Yadav
Issue:
Volume 6, Issue 5, September 2017
Pages:
80-81
Received:
25 January 2017
Accepted:
1 March 2017
Published:
19 October 2017
Abstract: Priapism is a rare and unusual presentation in Emergency Department of Nepal and is really a challenge for the working Emergency Physicians. In Nepalese context it is a social stigma and is often a pitfall due to possible delayed presentation. A young Nepalese Hindu male presented to our Emergency Department with post coital priapism who seeked help only after ninety-six hours in request of his wife. In limited resource hospital settings with delayed presentation, aspiration and irrigation of corpora cavernosa with heparinized saline had shown good outcome in treatment of priapism without any postoperative complications regardless of prolonged stay in emergency department.
Abstract: Priapism is a rare and unusual presentation in Emergency Department of Nepal and is really a challenge for the working Emergency Physicians. In Nepalese context it is a social stigma and is often a pitfall due to possible delayed presentation. A young Nepalese Hindu male presented to our Emergency Department with post coital priapism who seeked hel...
Show More
-
Case Reports on Juvenile Xanthogranuloma and Brief Review of Literature
Sushmita Pradhan,
Shuang Chen,
Lin Xiong
Issue:
Volume 6, Issue 5, September 2017
Pages:
82-85
Received:
18 February 2017
Accepted:
18 March 2017
Published:
24 October 2017
Abstract: Juvenile xanthogranuloma is an unusual, self-limiting dermatological disorder occurring especially in infants, late childhood and rarely in adults. It belongs to the broad group of non-Langerhans cell histiocytosis. It usually appears as solitary or multiple papules, macules or nodules several millimeters in diameter with the head and neck being the most common site of involvement and vulva being the rare site. We report two cases of juvenile xanthogranuloma in an 18 months old female and 18 months old male. The female presented with three yellow papules measuring 2-3 mm in diameter around vulva region since 4 months. Similarly, the male presented with multiple tan-orange color macules on head and forehead measuring 3-4mm in diameter since 6 months. In both the cases, a biopsy without total excision was performed. The clinical and histopathological evaluation confirmed the diagnosis of juvenile xanthogranuloma. In childhood, juvenile xanthogranuloma is necessary to differentiate from another probable differential diagnosis by biopsy.
Abstract: Juvenile xanthogranuloma is an unusual, self-limiting dermatological disorder occurring especially in infants, late childhood and rarely in adults. It belongs to the broad group of non-Langerhans cell histiocytosis. It usually appears as solitary or multiple papules, macules or nodules several millimeters in diameter with the head and neck being th...
Show More
-
Evaluation of Analgesic Usage in Pain Management in Bingham University Teaching Hospital
Modupe Iretiola Builders,
Amos Paul Bassi
Issue:
Volume 6, Issue 5, September 2017
Pages:
86-90
Received:
18 January 2017
Accepted:
3 February 2017
Published:
24 October 2017
Abstract: Inappropriate analgesic prescriptions is associated with poor management of pain leading to low recovery, high morbidity, increase hospital stay, decrease patient satisfaction, high costs of admission and adverse drug reactions. Therefore, the aim of this study is to assess the analgesic usage by the medical prescribers at the inpatient and outpatient clinic of a teaching hospital. The study was a descriptive cross-sectional analgesic utilization study, the age, sex, the drugs prescribed per patient were recorded and analgesic prescriptions were analyzed by Pearson test and statistical significance was determined at P<0.05. A total of 2920 prescriptions were analyzed, 88.9% of the patients were prescribed analgesics, 51.9% were males, majority of them were between 21 to 41 yrs (30.5%). Acetaminophen was the most prescribed analgesic (46.1%), the most prescribed analgesic combination was ketoprofen and ibuprofen (14.4%), 75.6% of the patients were placed on analgesic oral dosage forms and majority of these drugs were prescribed in generic names.
Abstract: Inappropriate analgesic prescriptions is associated with poor management of pain leading to low recovery, high morbidity, increase hospital stay, decrease patient satisfaction, high costs of admission and adverse drug reactions. Therefore, the aim of this study is to assess the analgesic usage by the medical prescribers at the inpatient and outpati...
Show More
-
Comparative Analysis of Pediatric and Adult Leptospirosis in Pleven Region, Bulgaria
Issue:
Volume 6, Issue 5, September 2017
Pages:
91-97
Received:
18 February 2017
Accepted:
11 March 2017
Published:
24 October 2017
Abstract: Leptospirosis is worldwide re-emerging zoonosis with protean clinical manifestations. The more common mild, anicteric form is characterized by nonspecific symptoms such as fever, headache, chills, myalgia, nausea and abdominal pain. The severe, potentially fatal form (Weil’s disease) typically presenting as triad of jaundice, acute renal failure (ARF), and hemorrhage is estimated to occur in 5-15% of all human infections with mortality rate up to 40%. Elder age is one of poor prognostic factors in leptospirosis. There are few studies about leptospirosis in children and no one comparative study of pediatric and adult leptospirosis in regions with temperate climate. Our aims were to describe retrospectively the disease spectrum and outcome differences in children and adults with leptospirosis over a period of 41 years and to compare severity in different age groups. The study material comprised the data from 105 consecutive leptospirosis cases from Central Northern Bulgaria treated in Clinic of Infectious Diseases at University Hospital – Pleven (1976-2016) (95 male, age 37±18 years, lethal outcome in 12.38%), followed by comparative analysis of group of children (age ≤17-years-old; N1=13) versus group of adults (age ≥18 years-old; N2=92). Results: Fever (100%), hepatomegaly (92%), conjunctival suffusions (88%), myalgia (87%), nausea and vomiting (84%), shivering (79%), splenomegaly (74%), headache (65%), jaundice (64%), oliguria (58%), tachycardia (55%), hypotension (50%), abdominal pain (41%), and hemorrhagic diathesis (37%) were the most characteristic manifestations in whole series. Only headache and meningitis had had a significantly higher prevalence in the group of children. Leucocytosis, blood urea nitrogen, serum creatinine, serum bilirubin, aminotransferases, gamma glutamyl tranferase (GGT) and serum amylase levels were significantly higher in group of adults. Potassium level, total protein and albumins were significantly lower in the same group. The distribution of cases in whole series according to severity was as follows: mild cases – 27, moderate – 44 cases and severe – 34 cases. In group of children seven mild and six moderate cases had been observed versus 20 mild, 38 moderate and 34 severe cases in the group of adults. All thirteen deceased patients were adults. We concluded that in Pleven region, leptospirosis in children usually is mild and anicteric. The leptospiral meningitis is not unusual manifestation for pediatric leptospirosis. The major factors leading to death in adults with leptospirosis were lung edema and brain edema due to severe ARF.
Abstract: Leptospirosis is worldwide re-emerging zoonosis with protean clinical manifestations. The more common mild, anicteric form is characterized by nonspecific symptoms such as fever, headache, chills, myalgia, nausea and abdominal pain. The severe, potentially fatal form (Weil’s disease) typically presenting as triad of jaundice, acute renal failure (A...
Show More
