Incidence of low bone mineral density in patients with advanced prostate cancer before hormonal manipulation

Background: Prostate cancer is the second most commonly diagnosed cancer in men with an estimated 1.3 million cases diagnosed in 2018 according to the most recent International Agency for Research on Cancer (IARC) report.A large proportion of men still present with advanced disease and in this situation androgen deprivation therapy (ADT) is the mainstay of treatment.Prostate cancer is largely androgen-dependent and responds to endocrine therapy. ADT is an effective treatment modality which decreases the rate of disease progression, alleviates symptoms, and prolongs patients’ survival. ADT can be achieved through surgery (i.e., bilateral orchidectomy) or medical therapy (gonadotropin releasing hormone agonists, antagonists and antiandrogens).Methods: With the approval from institutional ethic committee, a case control study was planned at the urology outpatient department (OPD) at SMS Hospital from April 2019 to March 2020. Based on inclusion and exclusion criteria, 44 patients with newly diagnosed advanced prostate cancer and requiring hormone manipulation were enrolled in study. Age matched control (age±2 years) was selected from patients attending urology clinics with conditions other than prostate cancer. Ratio of cases and control was kept 1:1. Written consent was taken from all participants.Results: Total 88 patients were enrolled in study, 44 in each group. The age of patients ranged from 57 to 86 years among the case group and 55–85 among the control group. Mean age of cases was 65.24±6.8 and control was 64.98±7.6 years (p=0.25). Body mass index which is calculated with standard formula (weight in kg/height in meter square) was significantly high among controls (24.20±2.46) in comparison to cases (23.42±2.84). Statistically significant difference was observed among case and control groups for PSA (p=0.0001) and serum calcium (p=0.005) however difference for alkaline phosphatase (ALP), parathyroid hormone (PTH) and vitamin D was found insignificant (p>0.05).Conclusions: Low bone mineral density in patients with advanced prostate cancer before hormonal manipulation is nearly 50%. PSA and serum calcium level were significant different among case and control however this difference was not found for ALP, PTH and vitamin D. Consideration should be given to performing BMD studies in these men before initiating treatment, to avoid or minimize potential bone-related complications in these patients

A Randomized Controlled Trial to Compare the Safety and Efficacy of Tadalafil and Tamsulosin in Relieving Double J Stent Related Symptoms

Objectives. To evaluate the safety and efficacy of Tadalafil and Tamsulosin in treating Double J stent related symptoms. Methods. In a prospective study, 161 patients with DJ related symptoms were randomized into 3 groups: Group A patients (54), Group B patients (53), and Group C patients (54). They were given Tadalafil, Tamsulosin, and placebo, respectively, at 1st week till removal of DJ stent at 3rd week. All patients completed Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and at 3rd week. The statistical significant difference among groups was determined by the t-test, Kruskal-Wallis test and multivariate analysis were used to assess association of the variables within the three groups, and the level of significance was set at P<0.05. Results. Tadalafil and Tamsulosin were comparable in relieving urinary symptoms, general health, and work performance (OR = 0.65, 1.8, and 0.92). But Tadalafil was more effective in relieving body pain, sexual problems, and additional problems than Tamsulosin (OR = 5.95, 19.25, and 2.69) and was statistically significant as P<0.05. Conclusion. Tadalafil was as effective as Tamsulosin in relieving urinary symptom but more effective in relieving sexual symptoms and body pain

Large Genital Cavernous Hemangioma: A Rare Surgically Correctable Entity

We report a case of 24-year-old male presenting with painless penoscrotal swelling for 3 years. On examination, a large soft bag of worm-like, superficial, nonpulsatile swelling was present in scrotum and penis. Color Doppler showed dilated tortuous vessels and on angiography no connections to corpora or vessels were seen. So a diagnosis of hemangioma was made and a surgical excision was carried out by circumcoronal and scrotal incisions. Postop course was uneventful. At 6 months of follow-up, no recurrence was seen and wound had healed with excellent cosmetic appearance

Adrenal myelolipoma with osseous metaplasia and hypercortisolism

Adrenal myelolipomas are rare adrenal tumors generally diagnosed incidentally. A 42-year-old female reported to us with complaints of left flank pain attributable to her left ureteric calculi. On evaluation, a large adrenal mass was diagnosed along with hypercortisolism. After adrenalectomy, the histopathology revealed adrenal myelolipoma along with osseous metaplasia not reported in English literature, to the best of our knowledge till date

Assessment of factors affecting the spontaneous passage of lower ureteric calculus on the basis of lower ureteric calculus diameter, density, and plasma C- reactive protein level

Introduction: The study aimed to evaluate the factors which affect the spontaneous passage of lower ureteric calculus on the basis of noncontrast computed tomography kidneys, ureters, and bladder (NCCT KUB) stone diameter, stone density, and plasma C-reactive protein (CRP) level. Materials and Methods: We conducted a prospective study of 200 patients with lower ureteric calculus 5–10 mm in size, from October 2015 to December 2016. All patients underwent NCCT KUB region with a 5 mm axial and reformatted coronal section. Edema just above the calculus and rim sign at the level of calculus and density of calculus is evaluated. Only scan with isolated, unilateral, solitary ureteric calculus was included in the final analysis and monitored up to 4 weeks, and plasma CRP is estimated in all patients to determine the clinical outcome. Results: A total of 200 patients (145 males, 55 females; mean age ± standard deviation, 34.73 ± 10.29) were included in the study. Lower ureteric calculus between 5–7 mm passed in 70% and 7–10 mm passed in 40%. There was 18% underestimation of maximum stone diameter in axial plane as compared to coronal plane. For spontaneous passage of calculus, craniocaudal (CC) diameter is more reliable then axial in NCCT. Rim sign and edema is absent in 64% of those passed spontaneous calculus. CRP level more than 2.45 mg/dl has low spontaneous expulsion rate. The stone with different HU passes through the ureter with same rate. Conclusion: Plasma CRP level and CC diameter and absence of rim sign on NCCT KUB are more reliable factors then density for spontaneous passage of ureteric calculus

Wastewater Treatment with Technical Intervention Inclination towards Smart Cities

At this time, efforts are being made on a worldwide scale to accomplish sustainable development objectives. It has, thus, now become essential to investigate the part of technology in the accomplishment of these Sustainable Development Goals (SDGs), as this will enable us to circumvent any potential conflicts that may arise. The importance of wastewater management in the accomplishment of these goals has been highlighted in the study. The research focuses on the role of fourth industrial revolution in meeting the Sustainable Goals for 2030. Given that water is the most important resource on the planet and since 11 of the 17 Sustainable Goals are directly related to having access to clean water, effective water management is the most fundamental need for achieving these goals. The age of Industry 4.0 has ushered in a variety of new solutions in many industrial sectors, including manufacturing, water, energy, healthcare, and electronics. This paper examines the present creative solutions in water treatment from an Industry-4.0 viewpoint, focusing on big data, the Internet of Things, artificial intelligence, and several other technologies. The study has correlated the various concepts of Industry 4.0 along with water and wastewater management and also discusses the prior work carried out in this field with help of different technologies. In addition to proposing a way for explaining the operation of I4.0 in water treatment through a systematic diagram, the paper makes suggestions for further research as well

Wastewater Treatment with Technical Intervention Inclination towards Smart Cities

At this time, efforts are being made on a worldwide scale to accomplish sustainable development objectives. It has, thus, now become essential to investigate the part of technology in the accomplishment of these Sustainable Development Goals (SDGs), as this will enable us to circumvent any potential conflicts that may arise. The importance of wastewater management in the accomplishment of these goals has been highlighted in the study. The research focuses on the role of fourth industrial revolution in meeting the Sustainable Goals for 2030. Given that water is the most important resource on the planet and since 11 of the 17 Sustainable Goals are directly related to having access to clean water, effective water management is the most fundamental need for achieving these goals. The age of Industry 4.0 has ushered in a variety of new solutions in many industrial sectors, including manufacturing, water, energy, healthcare, and electronics. This paper examines the present creative solutions in water treatment from an Industry-4.0 viewpoint, focusing on big data, the Internet of Things, artificial intelligence, and several other technologies. The study has correlated the various concepts of Industry 4.0 along with water and wastewater management and also discusses the prior work carried out in this field with help of different technologies. In addition to proposing a way for explaining the operation of I4.0 in water treatment through a systematic diagram, the paper makes suggestions for further research as well

STONE score versus Guy's Stone Score - prospective comparative evaluation for success rate and complications in percutaneous nephrolithotomy

Purpose: The aim of the current study was to compare Guy's score and STONE score in predicting the success and complication rate of percutaneous nephrolithotomy (PCNL). Materials and Methods: A total of 445 patients were included in the study between July 2015 and December 2016. The patients were given STONE score and Guy's Stone Score (GSS) grades based on CT scan done preoperatively and intra- and post-operative complications were graded using the modified Clavien grading system. The PCNL were done by a standard technique in prone positions. Results: The success rate in our study was 86.29% and both the GSS and STONE score were significantly associated with a success rate of the procedure. Both the scoring systems correlated with operative time and postoperative hospital stay. Of the total cases, 102 patients (22.92%) experienced complications. A correlation between STONE score stratified into low, moderate, and high nephrolithometry score risk groups (low scores 4–5, moderate scores 6–8, high scores 9–13), and complication was also found (P = 0.04) but not between the GSS and complication rate (P = 0.054). Conclusion: Both GSS and STONE scores are equally effective in predicting success rate of the procedure