Age and Prostatic Volume: The Prognosis for Benign Prostatic Hyperplasia

Background: Old age is more susceptible to prostatic sicknesses. Benign prostatic hyperplasia (BPH) is related to repeated urinary tract infections, which influences personal satisfaction. The values of prostatic volume and obesity are viewed as significant factors for the advancement of prostate organ hypertrophy. The study aimed to investigate the effect of age on benign prostatic hyperplasia patients in a tertiary care hospital in Karachi. Methods: A cross-sectional study was conducted in an emergency clinic of Dr. Ruth Pfau and Dow College of health sciences on 60 enrolled patients (50-80 years). All selected patients had BPH and were assessed by a Global prostate side effect score >7. Patients with BPH were divided into two groups obese and non-obese. Transrectal ultrasound was performed to analyze the length, width, diameter and volume of the prostate. The outcomes were then examined to observe the progressions in the morphological construction of the prostate and its relationship with the advancement of age. Results: The mean prostate volume (PV) was higher in the obese group measuring 36.13±3.673ml while in the non-obese group, it was 31.21±6.771 ml, the difference was statistically significant (p=0.001). In the 60-70 years, age group, we obtained the highest count of obese participants with PV ≥ 30ml. In 71-80 years, age groups, again the maximum number of participants had ≥ 30ml PV and were obese. Conclusion:  In the study, patients’ obesity had a significant effect on the prostate volume (p<0.001). Thus, benign prostatic hypertrophy was seen in the higher age group (60-70 years). Keywords: Old Age, BPH, Prostatic Volume, Satisfaction

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1

10.1016/s0140-6736(21)00984-3The Lancet39810299503-52

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

10.1016/s0140-6736(21)01169-7The Lancet397102922337-236

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)