PURPOSE: The 5-alpha reductase inhibitors (5ARI) are one of the most commonly used medications for the treatment of benign prostatic hyperplasia (BPH). Phosphodiesterase type-5 inhibitors are also used to treat BPH. 5ARI is a drug with adverse effects of sexual dysfunction. In this study, we investigated the safety and efficacy of coadministration of finasteride and sildenafil on sexual function and lower urinary symptoms in patients with BPH. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who were receiving finasteride and sildenafil daily regimens for treatment of BPH in 2 university hospitals. Patients with adverse effects, vital sign, physical exam, laboratory test, 5-item version of the international index of erectile function (IIEF-5), International Prostate Symptom Score (IPSS), quality of life (QoL) were analyzed. RESULTS: The number of patients analyzed in this study was 218. The mean age of the patients was 62.63±8.37 years and the mean duration of medication was 18.23±10.97 weeks. Significant changes were not observed in the vital signs measured before and after the drug administration. Compared with before treatment, improvement of lower urinary tract symptom (IPSS: 17.56±4.21 vs. 11.64±5.33, p < 0.001) was observed and improvement of sexual function (IIEF-5: 9.44±5.21 vs. 12.73±6.81, p < 0.001) was also confirmed. CONCLUSIONS: Daily coadministration of finasteride and sildenafil for the treatment of BPH could be used safely, and improvement of lower urinary tract symptom as well as improvement of sexual function could be expected.
5-alpha Reductase Inhibitors ; Erectile Dysfunction ; Finasteride ; Hospitals, University ; Humans ; Lower Urinary Tract Symptoms ; Male ; Medical Records ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Sildenafil Citrate ; Urinary Tract ; Vital Signs

This is a case of a 52 year-old female admitted in the medicine ward of the Philippine General Hospital (PGH) for drowsiness, fever and jaundice. This paper will illustrate an unusual case of encephalopathy, chronic abdominal pain and jaundice due to disseminated strongyloidiasis. Four months prior to admission (PTA), the patient sought consult for on and off right lower quadrant abdominal pain, easy fatigability, generalized body weakness, and vomiting of previously ingested food. Physical examination revealed pallor, right costovertebral angle and right lower quadrant abdominal tenderness. Work-up done showed a urinary tract infection and hookworm. An ultrasound of the kidneys and urinary bladder did not reveal any renal abscess and showed only a hyperechoic mass confirmed to be angiomyolipoma by abdominal CT scan. Bilateral renal cysts were also noted. Treatment for the urinary tract infection and hookworm were prescribed. She was lost to follow up.
Human ; Female ; Middle Aged ; PARASITIC DISEASES ; STRONGYLOIDIASIS ; SIGNS AND SYMPTOMS ; ULTRASONOGRAPHY

Human ; Female ; Adult ; Female urogenital diseases ; radiography ; tomography scanners ; signs and symptoms ; diagnostic imaging

This patient is a 38 year old housewife who has been hypertensive and hypokalemic since age 23. She suffered her first stroke at age 32 and a seizure just one week prior to admission. This paper will discuss the clues to the diagnosis of secondary hypertension.
Human ; Female ; Adult ; HYPERTENSION ; CARDIOVASCULAR DISEASES ; VASCULAR DISEASES ; HYPOKALEMIA ; NUTRITIONAL AND METABOLIC DISEASES ; METABOLIC DISEASES ; WATER-ELECTROLYTE IMBALANCE ; MUSCLE WEAKNESS ; SIGNS AND SYMPTOMS ; PATHOLOGICAL CONDITIONS, SIGNS AND SYMPTOMS ;

Superior semicircular canal dehiscence (SSCD) syndrome is an unusual cause of vertigo that was first identified by Minor in 1998. The patients initially described by Minor presented with vertigo, oscillopsia and/or dysequilibrium related to sound, changes in middle ear pressure and/or changes in intracranial pressure due to an absence of the bony layer that normally covers the superior semicircular canal.1Subsequent clinical studies have shown that the condition may lead to a variety of vestibular and/or auditory symptoms that mimic other otologic disorders. These symptoms include autophony, ear blockage or fullness, conductive hearing loss, pulsatile tinnitus, dizziness or vertigo with head movements and general disequilibrium.
Human ; SEMICIRCULAR CANALS ; IMAGE PROCESSING, COMPUTER-ASSISTED ; IMAGE RECONSTRUCTION ; TOMOGRAPHY SCANNERS, X-RAY COMPUTED ; VERTIGO ; SYMPTOMS ; SIGNS AND SYMPTOMS ; DIAGNOSIS

OBJECTIVES: To compare the effect of Tramadol, Tramadol/HNBB combination and Tramadol/Alfuzosine combination in the relief of renal colic.

MATERIALS AND METHODS: A total of 82 patients diagnosed with renal colic from May to October 2009 were included in the study. The patients were divided into three groups: Group I (n=27) was given Tramadol (50 mg/capsule orally) only, Group II (n=28) was given Tramadol and Hyoscine-N-Butylbromide (10 mg/tablet orally) and Group III was given Tramadol and Alfuzosine (10 mg/tablet orally). Pain was evaluated using the Visual Analog Scale pre-treatment and post-treatment.

RESULTS: The Visual Analog Scale scores for all groups showed improvement after treatment. The average difference in Visual Analog Scale for Group I was 3.148, Group II was 3.444, and Group III was 3.429. A significant difference was seen in all treatment groups. ANOVA was used to compare the differences between the three treatments. All treatments had comparable results, therefore, no significant difference was seen in the effect of the three treatments.

CONCLUSION: Relief of renal colic was achieved in all groups as seen in a decrease in the Visual Analog Scale Score after giving of treatment, however, the differences for each treatment group was not statistically significant.

Introduction: We recently developed a scoring system for diagnosis of acute appendicitis. This study prospectively evaluates the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score for the diagnosis of acute appendicitis in patients presenting to the Accident & Emergency department or the Surgical wards with right iliac fossa pain. Materials and Methods: From November 2008 to April 2009, consecutive patients presenting to the Accident & Emergency department or the surgical wards with right iliac fossa pain were recruited for the study. The RIPASA score was applied but the decision for radiological investigations or emergency appendicectomy was made based on clinical judgement. Receiver operating curve (ROC), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the new scoring system were derived. Ethical approval for the study was obtained from the Medical & Health Review Ethics Committee. Results: Within six months, 144 consecutive patients with a mean age of 29.5 ± 13.3 yrs were recruited to the study. Ninety-eight patients underwent emergency appendicectomy of which 79 were confirmed histologically for acute appendicitis. The observed negative appendicectomy rate was 19.4%. The optimal cut-off threshold score from the ROC was 7.5, with a sensitivity of 97.5%, specificity of 81.8%, PPV of 86.5%, NPV of 96.4% and a diagnostic accuracy of 91.8%. The predicted negative appendicectomy rate was 13.5%, which is a 5.9% reduction from the observed rate of 19.4% (p=0.3). Conclusion: The RIPASA score is a more suitable appendicitis scoring system developed for our local settings with a population that is reflective of our region in South-east Asia and has high sensitivity, specificity and diagnostic accuracy.
Appendicitis ; Appendectomy ; Diagnostic Techniques and Procedures ; Surgical Procedures, Operative ; Signs and Symptoms

Among 604 samples gathered from respiratory inflammation patients at Thai Binh Hospital, 264 samples of Streptococcus pneumonia (43.7%) were isolated, similarily 108 of Streptococcis pyogenes (17.9%), 93 of Klebsiella pneumonia (15.4%), 49 of Staphyllococcus aureus (8.1%), 23 of Pseudomonas aeruginosa (3.8%), 21 of Proteus (3.5%), 19 of Haemophylus (3.1%) were. Different levels of antibiotic resistance of these bacteria were determined
Inflammation ; Bacteria ; Patients ; Respiratory System ; Respiratory Tract Infections ; Signs and Symptoms, Respiratory

The authors report the clinical and pathological study of three cases of parathyroid adenoma diagnosed and surgically treated at ViÖt §øc hospital during 3 years (2000-2002). The clinical and paraclinical symptoms were typical. One case showed symptoms of bone disease with the features of classic osteitis fibrosa cystica or Von Reckling Hausen disease. One patient had clinical features of peptic ulcer and one case had compressive symptoms of neck mass. Two patients had a features of too high and continuous hypercacimia (>3.2 mmol/l). The third case had normally laboratory findings. All tumors had typical pathological features of parathyroid adenoma. Two cases had been diagnosed and treated late and one patient was diagnosed as thyroid cyst. The clinical and paraclinical symptoms were discussed
Parathyroid Neoplasms ; Pathological Conditions, Signs and Symptoms

The study was performed on 80 chronic renal failure(CRF) subjects. Initial results: Clinical respiratory manifestation: The main respiratory symptom in CRF: chest pain 60,49%, cough 46,25%. There is not significant difference in respiratory symptoms between CRF with intermittent dialysis (P>0.05). Physical symptoms: Crepitating 48,75%, rough vesicular breathing 37,5%. Vesicular breathing and crackle in CRF with intermittent dialysis were significantly higher (P<0,01). Lung radiographic features: There are 8 lesions on lung X-ray, main lesions: lung calcification 80%, large-lung hilar syndrome 71%, lung manifestation in hyperuremia 32,5%, pleural effusion 26,25%. Lung calcification and large lung hilar-syndrom in CRF with ID were higher (P<0,01). There is a relationship between the lesions on chest X-ray and hyperuremia level.
Kidney Failure ; Lung ; Signs and Symptoms, Respiratory