Prostate cancer: pathophysiology, diagnosis, and prognosis

Prostate cancer is more common in the western countries, least common in Asia, and the leading cause of cancer deaths in males worldwide. Individuals who have first-degree family members with prostate cancer have double the risk of getting disease. Risk factors for prostate cancer include family history ,genetics,diet, medication, infectious disease and sexual factors. Published animal research studies indicate that basal cells developed cancerous tumors, which appeared identical to human samples. Initially adenocarcinoma a condition known as carcinoma in situ or prostate intraepithelial neoplasia(PIN).Although there is no proof that PIN is a precursor, it is closely associated with cancer. Prostate cancer is associated with urinarydysfunction. Advanced cancer can spread to other parts of the body, i.e. Vertebrae, pelvic, or ribs, also compress the spinal cord, causing tingling leg weakness and urinary and fecal incontinence. Diagnosis by digital rectal examination(DRE),biopsy, Gleason score, and TNM staging(Tumor/nodes/metastasis) and by tumor markers. Management options best depends on the stage of the disease, the Gleason score and PSA level. If radiation fails then surgery may not be feasible, and radiation after surgery failure may have complications, associated with small increase in bladder and colon cancer. Prognostic indicators of disease outcome are stage, pre-therapy PSA level and Gleason score, higher the grade, and the stage poorer the prognosis.Information on the relationship of diet and prostate cancer is poor. American Urological Association(AUA) recommends screening in those of 55 to 69,no more than every two years

Acute and chronic rhinosinusitis, pathophysiology and treatment

Acute sinusitis (ARS) and chronic rhinosinusitis (CRS) is a common condition worldwide.CRS is due to the infection and inflammation of paranasal sinuses. Frequent clinical manifestations of ARS include persistent symptoms with nasal discharge or cough or both, presentation with fever accompanies purulent nasal discharge, and worsening symptoms. Complications of CRS have five stages, preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess and cavernous sinus septic thrombosis. Most acute sinusitis generally of viral origin, e,g. rhinoviruses, corona viruses,and influenza viruses. Bacterial pathogen include Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis. Bacteria found in biofilms have their antibiotic resistant increased up to 1000 times when compared to bacteria free living of same species. Sinusitis also results from fungal invasion in patients with diabetes, immune deficiencies, and AIDSor transplant patients. Bacterial and viral sinusitis are difficult to distinguish. The diagnosis of acute sinusitis should be on clinical presentation in most patients CT scan of sinuses is useful for patients with complications and in patients in whom sinus surgery is considered. MRI may have a role in the diagnosis of fungal rhinitis. The benefit of Functional Endoscopic Sinus Surgery (FESS) is its ability for a more targeted approach. Recently developed treatment by balloon sinuplasty is promising. A short-course of antibiotics is helpful in clinically diagnosed bacterial sinusitis without complicating factors