Incidence of hip fracture in Saudi Arabia and the development of a FRAX model

Summary A prospective hospital-based survey in representative regions of Saudi Arabia determined the incidence of fractures at the hip. The hip fracture rates were used to create a FRAX® model to facilitate fracture risk assessment in Saudi Arabia. Objective This paper describes the incidence of hip fracture in the Kingdom of Saudi Arabia that was used to characterize the current and future burden of hip fracture, to develop a country-specific FRAX® tool for fracture prediction and to compare fracture probabilities with neighbouring countries. Methods During a 2-year (2017/2018) prospective survey in 15 hospitals with a defined catchment population, hip fractures in Saudi citizens were prospectively identified from hospital registers. The number of hip fractures and future burden was determined from national demography. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Saudi Arabia. Fracture probabilities were compared with those from Kuwait and Abu Dhabi. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 2,949 and is predicted to increase nearly sevenfold to 20,328 in 2050. Hip fracture rates were comparable with estimates from Abu Dhabi and Kuwait. By contrast, probabilities of a major osteoporotic fracture or hip fracture from the age of 70 years were much lower than those seen in Abu Dhabi and Kuwait due to higher mortality estimates for Saudi Arabia. Conclusion A country-specific FRAX tool for fracture prediction has been developed for Saudi Arabia which is expected to help guide decisions about treatment

Urethral stricture disease after bipolar prostatectomy: Is it a concern?

Introduction: bipolar Transurethral Surgery of Prostate (BTUSP) is growing increasingly popular in the management of Benign prostatic hyperplasia related lower urinary tract symptoms (BPH-related LUTS). Compared to monopolar transurethral resection of the prostate (TURP), BTUSP has the potential advantages of less toxicity related to irrigation fluid absorption, and better hemostasis. However, there have been reports of BTUSP being associated with increased incidence of urethral stricture disease (USD). We aim at 2 years results of B-TUSP with special emphasis on USD and continence. Patients and methods: This is a retrospective study of patients who underwent BTUSP (resection, vaporization and enucleation) for BPH-related LUTS at Cairo University Hospital from January 2013 to December 2014. Perioperative parameters were assessed. Patients were evaluated 2 years postoperative to assess international prostate symptom score (IPSS), continence, urinary tract infection (UTI) uroflowmetry and post voiding residual urine (PVR). For patients with suspicion of USD (maximum flow rate “Qmax” ≤15 ml/s, PVR ≥100 cc,), retrograde and voiding cystourethrogram and/or cystoscopy were done. Results: A 2-years follow-up was available for 32 patients. Mean age was 66.2 ± 8.2 years. 16/32 patients were catheter dependent due to bladder outlet obstruction. Mean preoperative flowmetry, IPSS and adenoma size were 9.1 ± 3.02 ml/s, 23.1 ± 2.3 and 60.1 ± 28.1 g, respectively. Of our patients 11/32 (34%), 14/32 (44%) and 7/32 (22%) underwent BTU-enucleation, resection and vaporization of prostate, respectively. There was a difference in mean adenoma size for vaporization, enucleation and resection patients (29.57 ± 11.9 g, 83.36 ± 26.49 g and 58.71 ± 17.82 g, respectively) (p < 0.05). Mean postoperative catheter time was 2.7 ± 1.3 days, IPSS, Qmax, and PVRU at 2 years, were 4.53 ± 1.29 (2–7), 17.94 ± 2.7 (11–22) and 3.13 ± 7.7 (0–35) respectively, this was significantly different from preoperative Qmax and IPSS (p < 0.05). Eight patients with Qmax ≤15 ml/s (11–15 ml/s) were assessed and found not to have USD. None of our patients reported incontinence. At 2 years, there was no significant difference in mean Qmax for vaporization, resection and enucleation (18 ml/s ± 3.4, 18.71 ml/s ± 2.86, and 16.9 ml/s ± 1.86, respectively) (p = 0.267). Conclusion: BTUSP is a safe and effective modality for surgical management of BPH-related LUTS. With no evidence of increased incidence of USD, and with significant improvement of flowmetry and IPSS after 2 years follow up. Keywords: Urethral stricture disease, Bipolar prostatectomy, Transurethral prostatic surger

Urethral stricture disease after bipolar prostatectomy: Is it a concern?

Introduction: bipolar Transurethral Surgery of Prostate (BTUSP) is growing increasingly popular in the management of Benign prostatic hyperplasia related lower urinary tract symptoms (BPH-related LUTS). Compared to monopolar transurethral resection of the prostate (TURP), BTUSP has the potential advantages of less toxicity related to irrigation fluid absorption, and better hemostasis. However, there have been reports of BTUSP being associated with increased incidence of urethral stricture disease (USD). We aim at 2 years results of B-TUSP with special emphasis on USD and continence.Patients and methods: This is a retrospective study of patients who underwent BTUSP (resection, vaporiza- tion and enucleation) for BPH-related LUTS at Cairo University Hospital from January 2013 to December 2014. Perioperative parameters were assessed. Patients were evaluated 2 years postoperative to assess inter- national prostate symptom score (IPSS), continence, urinary tract infection (UTI) uroflowmetry and post voiding residual urine (PVR). For patients with suspicion of USD (maximum flow rate “Qmax”≤15 ml/s, PVR ≥100 cc,), retrograde and voiding cystourethrogram and/or cystoscopy were done.Results: A 2-years follow-up was available for 32 patients. Mean age was 66.2 ± 8.2 years. 16/32 patients were catheter dependent due to bladder outlet obstruction. Mean preoperative flowmetry, IPSS and adenoma size were 9.1 ± 3.02 ml/s, 23.1 ± 2.3 and 60.1 ± 28.1 g, respectively. Of our patients 11/32 (34%), 14/32 (44%) and 7/32 (22%) underwent BTU-enucleation, resection and vaporization of prostate, respectively. There was a difference in mean adenoma size for vaporization, enucleation and resection patients (29.57 ± 11.9 g, 83.36 ± 26.49 g and 58.71 ± 17.82 g, respectively) (p &lt; 0.05). Mean postoperative catheter time was 2.7 ± 1.3 days, IPSS, Qmax, and PVRU at 2 years, were 4.53 ± 1.29 (2–7), 17.94 ± 2.7 (11–22) and 3.13 ± 7.7 (0–35) respectively, this was significantly different from preoperative Qmax and IPSS (p &lt; 0.05). Eight patients with Qmax ≤15 ml/s (11–15 ml/s) were assessed and found not to have USD. None of our patients reported incontinence. At 2 years, there was no significant difference in mean Qmax  or vaporization, resection and enucleation (18 ml/s ± 3.4, 18.71 ml/s ± 2.86, and 16.9 ml/s ± 1.86, respectively) (p = 0.267).Conclusion: BTUSP is a safe and effective modality for surgical management of BPH-related LUTS. With no evidence of increased incidence of USD, and with significant improvement of flowmetry and IPSS after 2 years follow up

Growth performance and certain body measurements of ostrich chicks as affected by dietary protein levels during 2–9 weeks of age

The present work was conducted to examine the effects of dietary crude protein (CP) levels (18, 21 and 24%) on growth performance (Initial and final body weight, daily body weight gain, feed consumption, feed conversion and protein efficiency ratio) during 2-9 weeks of age and certain body measurements (body height, tibiotarsus length and tibiotarsus girth) at 9 weeks of age. A total of 30 African Black unsexed ostrich chicks were used in the present study in simple randomized design. The results of the present work indicated that initial and final live body weight, body weight gain, feed consumption, feed conversion of ostrich chicks were insignificantly affected by dietary protein level used. Protein efficiency ratio was high in the group of chicks fed diet contained 18% CP. Results obtained indicated that tibiotarsus girth was decreased (P≤0.01) with the increasing dietary protein level, where the highest value of tibiotarsus girth (18.38 cm) was observed in chicks fed 18% dietary protein level. Body height and tibiotarsus length were not significantly different. In conclusion, the results of the present study indicate that ostrich chicks (during 2-9 weeks of age) could grow on diets contain lower levels of CP (18%)

Aspects of urinary tract infections and antimicrobial resistance in hospitalized urology patients in Asia: 10-Year results of the Global Prevalence Study of Infections in Urology (GPIU)

10.1016/j.jiac.2017.11.013Journal of Infection and Chemotherapy244278-283JICH