EFFICACY OF GOKSHURADI GUGGULU, SHUDHA SILAJIT AND DASHMOOL GHRUTA IN BENIGN PROSTATIC HYPERPLASIA (ASTHEELA) – AN OPEN OBSERVATIONAL STUDY

Objective: To assess the clinical efficacy of Goksuradi gugulu, Shudha Silajeet and Dashamula ghruta vasti in the management of Astheela (BPH). Materials and Method: This is an interventional, open, perspective, non-controlled, single group assigned study, designed to evaluate efficacy of Ayurvedic medicine on BPH (Astheela) studied on 40 patients. The study period was 84 days. Results: MFRml/S (Maximum flow rate) at base line was 12.1400 which was increased to 13.9475 ml/S at 84th day after treatment. Similarly the mean PVR (Post void Residual Urine) at base line was 147.5750ml which was reduced to 89.7500 ml after 84 days of treatment. The mean MLP (Median Lobe Projection) before treatment was 7.0375mm which was reduced to 6.5300mm, which is not statistically significant. The Mean Prostate Weight at base line was 38.0250 which was reduced to 37.9250 after treatment and was not statistically significant. The effect on symptoms was found to be satisfactory. The percentage of recovery in intermittent flow of urine was 96.15, in Poor flow of urine was 31.21. Similarly the percentage of recovery in incomplete emptying of bladder, dribbling of urine, retention of urine, urge incontinence, frequency was 95.24, 93.75, 83.34, 90, 97.44 and 92.6 respectively which was statistically significant. But no change in nocturnal incontinence was found

Vaporization of Prostatic Tissue to Treat Benign Prostatic Hyperplasia

The prostate is a key component of the male reproductive system. Often, due to age, the prostate becomes enlarged resulting in a condition known as Benign Prostatic Hyperplasia (BPH). While pharmacological options are generally the first choice, surgery is sometimes necessary to treat this condition. Laser procedures are ideal because of the decreased risks to the patient, but complications arise when the layer of coagulated tissue created by the laser becomes too thick. An ideal laser wattage and application time must be determined in order to minimize the coagulation layer while achieving an effective level of vaporization. The goal of this simulation was to create a model from which an ideal set of laser parameters for the laser treatment of BPH can be determined. This was achieved using finite-element analysis of the laser heating of a 2-dimensional axisymmetric prostate model using COMSOL Multiphysics software. Using this simulation, the vaporization and coagulation thicknesses in prostatic tissue treated for 5 seconds with a 40W, 80W, or 120W laser, or treated for 1 second with a 60W, 80W or 120W laser were determined. The results indicated that increasing laser wattage and/or application time increases the thickness of vaporized tissue and decreases the thickness of coagulation. Furthermore, the results suggested that the thickness of the coagulation zone converges to a minimum value as wattage and/or application time is increased. This simulation was preliminary; however, this model can ideally be used to determine an ideal laser wattage-application time combination that produces the desired level of vaporization while minimizing tissue coagulation

ОСОБЕННОСТИ ЛЕЧЕНИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ У МУЖЧИН С ОПУХОЛЬЮ ПОЧКИ ПОСЛЕ ЛАПАРОСКОПИЧЕСКОЙ НЕФРЭКТОМИИ

Objective of the study is to analyze the dynamics of blood pressure in the early postoperative period in patients with a tumor of the kidney and hypertension after laparoscopic nephrectomy. Group for laparoscopic nephrectomy selected 53 patients with hypertension aged 37–65 years. Duration hypertension patients with kidney tumors was 6.5 ± 3.2 years. All patients to assess the effectiveness of the primary purpose or need antihypertensive therapy before the surgery was conducted ambulatory blood pressure monitoring, and with the purpose of correction of antihypertensive therapy after surgery blood pressure monitoring performed on the second and tenth day using the monitor МECG-DS-HC-01. Strengthening of antihypertensive therapy took all the patients on the second day after the operation, on the tenth day correction of antihypertensive therapy was needed 32 patients (60.4%). Once added to the treatment scheme nifedipineretard the decline of some indicators of blood pressure monitoring on the tenth day of the postoperative period. Further reception of antihypertensive drugs after surgery allowed to achieve the target values of blood pressure

Alpha Satellite RNA Levels Are Upregulated in the Blood of Patients with Metastatic Castration-Resistant Prostate Cancer

The aberrant overexpression of alpha satellite DNA is characteristic of many human cancers including prostate cancer; however, it is not known whether the change in the alpha satellite RNA amount occurs in the peripheral tissues of cancer patients, such as blood. Here, we analyse the level of intracellular alpha satellite RNA in the whole blood of cancer prostate patients at different stages of disease and compare it with the levels found in healthy controls. Our results reveal a significantly increased level of intracellular alpha satellite RNA in the blood of metastatic cancers patients, particularly those with metastatic castration-resistant prostate cancer relative to controls. In the blood of patients with localised tumour, no significant change relative to the controls was detected. Our results show a link between prostate cancer pathogenesis and blood intracellular alpha satellite RNA levels. We discuss the possible mechanism which could lead to the increased level of blood intracellular alpha satellite RNA at a specific metastatic stage of prostate cancer. Additionally, we analyse the clinically accepted prostate cancer biomarker PSA in all samples and discuss the possibility that alpha satellite RNA can serve as a novel prostate cancer diagnostic blood biomarker

Affecting Factors of Prostate Volume in Forensic Autopsied Decedents

Because decedents undergoing forensic autopsies would have behaved normally before death, prostate volume according to age group can be confirmed with forensic autopsy materials. The objectives of this study were to first confirm the current prostate volume by age and then determine diseases that can influence prostate volume using forensic autopsy materials. Prostate specimens were collected from forensic autopsies performed at Shiga University of Medical Science, Japan, between January 2015 and December 2019. Overall, 207 decedents were included in the study. Prostate volume was measured by the Archimedes\u27 principle. Concomitant diseases were determined by the past medical histories and autopsy results. The mean crude prostate volume was 29.1 ± 10.3 mL (range, 2.8-88.0 mL). The crude prostate volume increased with age. The mean corrected prostate volume (divided by body surface area) was significantly higher in patients with atherosclerosis than in those without. However, multiple regression analysis revealed that only age influenced the corrected prostate volume. Age was the only significant influencing factor for prostate volume. We propose applying age estimation using prostate volume for forensic medicine purposes. Because prostate volume was not influenced by concomitant disease, it would be valuable to estimate the decedent\u27s age using the prostate volume

Leczenie nadciśnienia tętniczego u pacjenta z towarzyszącym łagodnym rozrostem stercza. Punkt widzenia hipertensjologa i urologa

U mężczyzn w podeszłym wieku nadciśnienie tętnicze często współistnieje z rozrostem gruczołu krokowego. Grupą leków wykorzystywaną w leczeniu obu tych chorób są α1-adrenolityki. W związku z tym przez wiele lat, zgodnie z zasadami indywidualizacji terapii hipotensyjnej, α1-adrenolityki uznawano za leki z wyboru w przypadku współistniejącego rozrostu stercza. Sytuację zmieniło ukazanie się wyników badania ALLHAT, w którym wykazano, że ryzyko incydentów sercowo-naczyniowych, a szczególnie nowych przypadków niewydolności serca, u pacjentów leczonych α1-adrenolitykiem jest istotnie większe niż w przypadku leczenia diuretykiem tiazydowym. Od tego czasu α1-adrenolityki nie są rekomendowane jako leki I rzutu również u pacjentów z towarzyszącym łagodnym rozrostem stercza, natomiast stanowią możliwy element terapii skojarzonej w III i IV rzucie. Istnieją trzy podtypy receptorów α1: A i D, zlokalizowane głównie w dolnych drogach moczowych i gruczole krokowym oraz receptory B, umiejscowione preferencyjnie w mięśniówce tętnic. Blokada receptorów α1A i α1D umożliwia poprawę zespołu dolegliwości ze strony dolnych dróg moczowych (LUTS) związanych z łagodnym rozrostem stercza, natomiast blokada receptorów α1B jest odpowiedzialna za efekt hipotensyjny, ale także za typowe objawy niepożądane α1-adrenolityków (hipotonia ortostatyczna, omdlenia związane z efektem pierwszej dawki). Leki α1-adrenolityczne dzieli się na nieuroselektywne (np. doksazosyna), czyli blokujące receptory α1A i α1B oraz uroselektywne (tamsulosyna), czyli blokujące preferencyjnie receptory α1A w sterczu. Jedynie α1-adrenolityki nieuroselektywne posiadają istotne działanie hipotensyjne, ale częściej wywołują działania niepożądane ze strony układu krążenia. Stosowane obecnie α1-adrenolityki posiadają preparaty o przedłużonym uwalnianiu, które stwarzają znacznie mniejsze ryzyko hipotonii ortostatycznej i powinny być preferowane. Leczenie nadciśnienia tętniczego i łagodnego rozrostu stercza powinno być prowadzone niezależnie przez hipertensjologa i urologa. Decyzja o wyborze leków hipotensyjnych leży w rękach hipertensjologa, który powinien kierować się ogólnymi zasadami terapii nadciśnienia u osób w podeszłym wieku. Decyzja o zastosowaniu α1-adrenolityka ze względu na objawy rozrostu stercza powinna należeć do urologa, z uwzględnieniem optymalnie bezpiecznego preparatu uroselektywnego, na przykład tamsulosyny, niezależnie od obecności nadciśnienia tętniczego. W przypadku konieczności intensyfikacji leczenia hipotensyjnego, hipertensjolog może podjąć, w porozumieniu z urologiem, decyzję o dołączeniu w III rzucie lub zamianie α1-adrenolityka uroselektywnego na nieuroselektywny, na przykład doksazosynę, o działaniu hipotensyjnym. Forum Medycyny Rodzinnej 2010, vol. 4, no 2, 97-10

The Translational Role of Animal Models for Estrogen-Related Functional Bladder Outlet Obstruction and Prostatic Inflammation

The prevalence of LUTS and prostatic diseases increases with age both in humans and companion animals, suggesting that a common underlying cause of these conditions may be age-associated alterations in the balance of sex hormones. The symptoms are present with different and variable micturition dysfunctions and can be assigned to different clinical conditions including bladder outlet obstruction (BOO). LUTS may also be linked to chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the relationship between these conditions is unknown. This review summarizes the preclinical data that supports a role for excessive estrogen action in the development of obstructive voiding and nonbacterial prostatic inflammation. Preclinical studies that are emphasized in this review have unequivocally indicated that estrogens can induce functional and structural changes resembling those seen in human diseases. Recognizing excessive estrogen action as a possible hormonal basis for the effects observed at multiple sites in the LUT may inspire the development of innovative treatment options for human and animal patients with LUTS associated with functional BOO and CP/CPPS

Alpha satellite RNA levels are upregulated in the blood of patients with metastatic castration-resistant prostate cancer

The aberrant overexpression of alpha satellite DNA is characteristic of many human cancers including prostate cancer; however, it is not known whether the change in the alpha satellite RNA amount occurs in the peripheral tissues of cancer patients, such as blood. Here, we analyse the level of intracellular alpha satellite RNA in the whole blood of cancer prostate patients at different stages of disease and compare it with the levels found in healthy controls. Our results reveal a significantly increased level of intracellular alpha satellite RNA in the blood of metastatic cancers patients, particularly those with metastatic castration-resistant prostate cancer relative to controls. In the blood of patients with localised tumour, no significant change relative to the controls was detected. Our results show a link between prostate cancer pathogenesis and blood intracellular alpha satellite RNA levels. We discuss the possible mechanism which could lead to the increased level of blood intracellular alpha satellite RNA at a specific metastatic stage of prostate cancer. Additionally, we analyse the clinically accepted prostate cancer biomarker PSA in all samples and discuss the possibility that alpha satellite RNA can serve as a novel prostate cancer diagnostic blood biomarker

Seminal vesicles: the normal development and function, congenital abnormalities and age-related changes (literature review)

Seminal vesicles are to add sexual glands and taking an important part in reproductive function. The function of seminal vesicles revealed only in the last half century and is studied fully. The close embryological, anatomical and functional relationships of the seminal vesicles with the urethra, prostate gland, vas deferens, epididymis, rectum, bladder and upper urinary ways and explains frequent concomitant defeat them for congenital anomalies, inflammatory and neoplastic diseases of the pelvic organs. The clinical significance of many age-related changes of the seminal vesicles remains unclear. The intrapartum and postnatal development, the function of the seminal vesicles; etiopathogenesis, diagnosis and clinical significance of defects and age-associated diseases of the seminal vesicles are discussed.Семенные пузырьки относятся к добавочным половым железам и принимают важное участие в репродуктивной функции. Функциональное предназначение семенных пузырьков раскрыто лишь в последние полвека и изучено неполностью. Тесные эмбриологические и анатомо-функциональные связи семенных пузырьков с уретрой, предстательной железой, семявыносящим протоком, придатком яичка, прямой кишкой, мочевым пузырем и верхними мочевыми путями объясняют частое и сочетанное поражение их при аномалиях развития, воспалительных и опухолевых заболеваниях органов малого таза. Клиническое значение многих возрастных изменений семенных пузырьков остается пока неясным. В литературном обзоре обсуждаются интранатальное и постнатальное развитие, функция семенных пузырьков; этиопатогенез, диагностика и клиническое значение пороков развития и возраст-ассоциированных заболеваний семенных пузырьков