Obstructive jaundice as a presenting symptom of metastatic carcinoma of the prostate.

Liver dysfunction is not an uncommon association with malignancy. However, obstructive jaundice as the first clinical presentation of metastatic carcinoma of the prostate is rare with only a few such cases reported in the literature. The aetiology of obstructive jaundice in these cases can be due to direct invasion of the tumour or external compression of the biliary tree or, rarely, related to a paraneoplastic phenomenon.

Assessment of urodynamic and detrusor contractility variables in patients with overactive bladder syndrome treated with botulinum toxin-A: is incomplete bladder emptying predictable?

Objective: To assess whether incomplete bladder emptying and the need for clean intermittent self-catheterization (CISC) is predictable, by analysing urodynamic and detrusor contractility variables in patients treated with botulinum toxin-A (BTX-A) for refractory idiopathic detrusor overactivity (IDO).

Patients And Methods: Sixty-seven patients (mean age 50.3) with IDO, from two centres, had bladder injections of 200 U BTX-A.

Dose-finding study with nicotine as a proconvulsant agent in PTZ-induced seizure model in mice.

The present study was conducted to investigate the possible interaction between low doses of nicotine and pentylenetetrazole (PTZ) in vivo and also to evaluate the influence of nicotine on the antiseizure efficacy of topiramate and sodium valproate in the PTZ-induced seizure model in mice. Graded dose-response study with nicotine showed the CD50 value for nicotine at 6.76 mg/kg.

Tracking of blood pressure among adolescents and young adults in an urban slum of puducherry.

Background: Early diagnosis of hypertension (HT) is an important strategy in its control. Tracking of blood pressure (BP) has been found useful in identifying persons with potential HT, particularly in youngsters. A cohort of 756 subjects (with baseline information as a cross-sectional study in 2002) was followed up in 2006 to comment on the distribution of BP and its attributes.

Urodynamic assessment of poor responders after botulinum toxin-A treatment for overactive bladder.

Objectives: Botulinum toxin-A (BTX-A) is effective in treating overactive bladder (OAB) refractory to anticholinergics. Most patients have improvements in symptoms, urodynamic parameters, and quality of life, and a poor response is uncommon. The aim of this study was to determine whether poor responders could be predicted from preoperative urodynamic parameters.

Evolution of transdermal oxybutynin in the treatment of overactive bladder.

Overactive bladder (OAB) syndrome affects millions of people worldwide. In addition to adversely affecting quality of life, the direct and indirect costs in managing patients with OAB incur a substantial financial burden on health services. Among the approved anticholinergics for treating OAB, oxybutynin is the most extensively studied drug in clinical trials.

Laparoscopic upper urinary tract surgery for benign and malignant conditions. Does aetiology have an effect on health-related quality of life?

Introduction: We present health-related quality of life (HRQoL) data on a cohort of patients undergoing upper urinary tract laparoscopy for a variety of benign and malignant conditions.

Patients And Methods: The Short Form 8 (SF-8) Health Survey is a validated HRQoL questionnaire that calculates scores for physical (PCS8) and mental (MCS8) components of health. It was administered prospectively to 58 patients.

Botulinum toxin for detrusor overactivity and symptoms of overactive bladder: where we are now and where we are going.

Botulinum toxin (BTX) treatment for overactive bladder and detrusor overactivity is becoming increasingly recognized as an excellent therapeutic option for treating patients refractory to anticholinergic agents. Results from open-label studies have suggested that this therapy is effective in neurogenic and idiopathic detrusor overactivity, yet validating evidence from randomized, placebo-controlled trials has been unavailable. The exact mechanism of action of BTX in the bladder is controversial, although evidence suggests that apart from preventing the presynaptic release of acetylcholine from the parasympathetic innervation to the bladder, it might have an effect on sensory mechanisms.

Rheumatic fever and rheumatic heart disease: primary prevention is the cost effective option.

Objective: To measure the economic output/input ratios for the various options of prevention of rheumatic fever/rheumatic heart disease (RF/RHD) and check the viability of primary prevention vis-à-vis secondary and tertiary preventions.

Methods: Cost accounting of the various prevention options was calculated for each variable as available in literature. Actual data as obtainable for the financial year ending March 2006 were computed for the Pondicherry population.

Day-case and short-stay surgery: the future for thyroidectomy?

Day-case and short-stay thyroid surgery is carried out routinely around the world. In the UK longer postoperative stay is usually advocated to circumvent/identify potentially catastrophic complications following thyroidectomy. In the current climate of the National Health Service with focus on patient-centred service, reduced hospital stay and cost cutting, we conducted a review to provide a comprehensive assessment of day-case and short-stay thyroidectomy.

Efficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: results from a single center, randomized, double-blind, placebo controlled trial.

Purpose: We evaluated the use of botulinum toxin-A in treating patients with idiopathic detrusor overactivity refractory to anticholinergics.

Materials And Methods: This double-blind, placebo controlled trial randomized participants to intradetrusor injections of 200 U botulinum toxin-A (16 patients) or placebo (18 patients). The primary outcome measure was change in maximum cystometric capacity.

Laparoscopic nephrectomy in a patient with ankylosing spondylitis: surgical and anesthetic challenges.

A 55-year-old man with ankylosing spondylitis was referred with left sided loin pain, loin mass, and painless macroscopic hematuria. Physical examination revealed a palpable loin mass, fixed flexion deformity of the lumbar and cervical spines, with severely restricted cervical movement and mouth opening. An ultrasound and computed tomography scan confirmed a 7-cm solid mass in the left kidney.

Laparoscopic retroperitoneal nephrectomy for giant hydronephrosis: when simple nephrectomy isn't simple.

Background And Purpose: Retroperitoneoscopic nephrectomy (RN) for giant hydronephrosis (GH) is regarded as a more challenging procedure than RN for small nonfunctioning kidneys (SNFK). We describe specific technical modifications to facilitate surgery in the GH group and compare outcomes in the two groups.

Patients And Methods: Data were collected in a prospective fashion on all patients undergoing upper urinary-tract laparoscopy at a single institution.

Evaluation of the modulatory role of nimodipine in seizures induced by kainic acid and pentylenetetrazole in mice.

The present study aimed at establishing the CD50 and CD99 doses along with complete dose-response profile of two convulsants, namely, kainic acid and pentylenetetrazole (PTZ), in mice and evaluating the modulatory role of the cerebroselective dihydropyridine calcium channel blocker nimodipine. Kainic acid and PTZ were administered intraperitoneally in a dose range of 1-30 mg kg(-1) and 35-75 mg kg(-1), respectively. Nimodipine was administered in graded doses (1-8 mg kg(-1), i.

In patients referred for investigation because computed tomography suggests thickened gastric folds, endoscopic ultrasound is superfluous if gastroscopy is normal.

Background And Objective: Endoscopic ultrasound (EUS) is often requested in patients in whom computed tomography (CT) shows gastric wall thickening. It is unclear if EUS is useful if upper endoscopy is normal. The aim of this study was to prospectively compare the yield of upper endoscopy and EUS for this indication.

Anti-seizure efficacy of nimodipine in pentylenetetrazole and kainic acid combined seizure models in mice.

The present study aimed at establishing two models of experimental seizures by combination treatment with subconvulsive doses of PTZ and kainic acid in adult male mice and evaluating the modulatory role of cerebroselective dihydropyridine calcium channel blocker, nimodipine. The CD50 +/- SEM value for PTZ was found to be 20.00 +/- 0.

Video consent: a pilot study of informed consent in laparoscopic urology and its impact on patient satisfaction.

Objectives: In the current climate of increasing awareness, patients are demanding more knowledge of the operative process. We report a new protocol for consenting patients. In addition to the normal consent process, patients are invited to watch a video of the operation to gain a perspective of what is involved.

Premalignant neoplasms and squamous cell carcinoma of the anal margin.

Premalignant and malignant lesions of the anal margin are rare. Understanding anal anatomy and performing a biopsy of any suspicious lesions are essential in avoiding a delay in diagnosis and appropriately treating these tumors. Wide local excision continues to remain the treatment of choice for many of these lesions.