International Journal of Urology and Nephrology

International Journal of Urology and Nephrology ISSN 2091-1254  Vol. 5 (4), pp. 165-167, April, 2017. © International Scholars Journals

Case Report

A rare presentation of hepatocellular carcinoma in a young adult: Case report

Erwa Elmakki

Department of Internal Medicine/Gastroenterology, Faculty of medicine, Jazan University, PO box 114,Jazan, Saudia Arabia Kingdom.

E-mail: [email protected]

Accepted 22 August, 2013

Abstract

Hepatocellular carcinoma (HCC) is the most frequent type of liver malignancy. Most cases of HCC are secondary to either viral hepatitis (hepatitis B, C) or alcoholic cirrhosis, however liver cirrhosis due to any other causes is considered as a risk factor for development of HCC. HCC in a young patient with no cirrhosis or fibrosis is a relatively rare condition. The present case report describes a young male (24-year-old) patient who presented with a 2-months history of fever, right upper quadrant abdominal pain and weight loss with no evidence of pre-existing liver disease, initially treated as liver abscess, however his CT abdomen with intravenous contrast showed numerous heterogeneous hepatic hypodensities many with ring enhancement, serum alphafetoprotein level found to be very high (>1000ng/l) and histological studies confirmed the presence of HCC. The present case findings suggest that mutltifocal HCC can occur in a young patient without having an apparent risk factors and clinical presentation of HCC can be similar to liver abscess.

Keywords: Hepatocellular carcinoma, liver malignancy, hepatitis, liver abscess, liver cirrhosis. 

International Journal of Urology and Nephrology ISSN 2091-1254  Vol. 5 (5), pp. 168-184, May, 2017. © International Scholars Journals 

Full Length Research Paper

Understanding patient and physician perceptions of benign prostatic hyperplasia in Japanese men: The Prostate Research on Behaviour and Education (PROBE) II survey

¹Satoru Takahashi, ²Yukiko Shima, ³Winston Wong, and ⁴Juan-Manuel Palacios-Moreno*

¹Department of Urology, Nihon University, Tokyo, Japan; ²GlaxoSmithKline, Tokyo, Japan; ³Ipsos Healthcare, London, UK, ⁴GlaxoSmithKline, Tres Cantos, Madrid, Spain.

*Corresponding author E-mail: [email protected]. Tel: +34 918070858, Fax: +44 (0) 161 445 0658

Accepted 30 May, 2017

Abstract

Objectives: To assess attitudes and beliefs towards benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and its treatment among Japanese patients and physicians. Methods: The Prostate Research on Behaviour and Education II quantitative survey used questionnaires to assess perceptions of 200 men with BPH/LUTS receiving drug treatment and 30 physicians treating BPH/LUTS. Results: One-quarter of patients reported not being adequately informed about BPH. Over 30% of patients did not consult, or delayed consulting, a physician when faced with initial symptoms. There was a disconnect between patients and physicians in the reasons for delayed consultation: 80% of physicians thought it was because men believed it was due to ageing, whereas only 39% of patients cited this reason. Moreover, physicians were generally less likely than patients to rate symptoms as severe at first presentation. Regarding progression, 70% of patients had never discussed surgery or acute urinary retention with their physician. Importantly, 33% of physicians reported tending not to take prevention of progression into account when deciding treatment. Conclusions: Areas of discordance exist between Japanese patients’ and physicians’ perceptions about BPH/LUTS, highlighting a need to proactively raise awareness to improve timely differential diagnosis and appropriate treatment, taking account of patients’ needs and preferences.

Keywords: Benign prostatic hyperplasia, lower urinary tract symptoms, Japan, patients, perceptions, physicians.

International Journal of Urology and Nephrology ISSN 2091-1254 Vol. 5 (3), pp. 151-155, March, 2017. © International Scholars Journals

Full Length Research Paper

A study of synergistic therapy of enalapril in the improvement of renal function in chronic allograft nephropathy patient

¹Bingwen Heng*, ²Ming-húa Jing, ²Xiaojian Qiang, ³Ming-tun Zian and ³Yingjie Dai

¹Department of Urology, Peking University Shougang Hospital, Beijing, China, ²Eighth Department, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing400042, China,³School of Medicine, Wuhan University, Wuhan, Hubei, China.

*Corresponding author. E-mail: [email protected].

Accepted  30 February, 2017

Abstract

Chronic allograft nephropathy (CAN) still remains an important factor that affects the long-term survival of renal recipients. The aim of the study was to investigate synergistic effect of enalapril (an angiotensin converting enzyme inhibitor, ACEI) and Cordyceps sinensis (Bailing capsule, fermented agent of C. sinensis) on CAN and pursue an effective therapy to control CAN progression. A total of 84 CAN patients who underwent transplantation (live related donor, no prisoners were used in this study) were involved in the study and randomized into four groups. Group A (n=22) received combined treatment of enalapril (10 mg/day) and C. sinensis (2.0 g/per times, three times per day), group B (n=20) was treated with enalapril (10 mg/day), group C (n=21) with C. sinensis (same dose as in group A) and group D (n=21) treated with immunosuppressive agents was set as control. Serum creatinine (SCr), blood urea nitrogen (BUN), creatinine clearance rate (CCr), urinary protein in 24 h (24 h Upro) and urinary transforming growth factor beta 1 (TGF-ß₁) of all patients were measured before treatment, and at six months after treatment. After treatment for six months, SCr and CCr were improved while 24 h Upro and urinary TGF-ß₁ decreased in group A , and SCr improved and 24 h Upro decreased in group C. Patients of group A obtained the highest degree of improvement, and more patients obtained renal improvement and stability than in the other groups. The results of the study show that combined use of enalapril and C. sinensis takes advantages of reducing excretion of urinary protein, improving renal function and retarding CAN progression for CAN patients compared with single use of enalapril or C.sinensis.

Key words: Chronic allograft nephropathy, renal transplantation, enalapril, Cordyceps sinensis.

International Journal of Urology and Nephrology ISSN 2091-1254 Vol. 5 (3), pp. 145-150, March, 2017. © International Scholars Journals

Full Length Research Paper

Prevalence of asymptomatic bacteriuria in prostatitis and non prostatitis subjects attending University of Port Harcourt Teaching Hospital

¹Tunde Omoniyi, ²Kayode Olaotan and ²Oyewale Olatunji

¹Department of Surgery, Faculty of Clinical Sciences, Osun State University, Osogbo, Nigeria.

²Department of Pathology, Faculty of Basic Clinical Sciences, State University, Osogbo, Nigeria.

*Corresponding author. E-mail: [email protected]. 

Accepted 04 December, 2016

Abstract 

This study was carried out to determine the prevalence of asymptomatic bacteriuria in Prostatitis subjects attending urology clinic at University of Port Harcourt Teaching Hospital (UPTH). Fifty eight (58) prostatitis subjects attending urology clinic at University of Port Harcourt Teaching Hospital and 54 apparently normal subjects working at University of Port Harcourt Teaching Hospital (UPTH) were used for this study. Inclusion and exclusion conditions were observed in patients’ selection. All the subjects had their blood Prostate specific antigen (PSA) determined by enzymes linked immunosorbent assay (ELISA). The urine samples were cultured on Cystine Lactose electrolyte deficient medium (CLED) and Chocolate agar by Standardized wire loop technique, incubated overnight at 37°C and the isolates identified. There was significant difference in PSA concentration of prostatitis subjects and controls (P<0.01). Prostatitis subjects had significant bacteriuria compared with the controls (P<0.05). Klebsiella spp was identified to be the predominant etiologic agent in prostatitis subjects while S. aureus was the prevalent uropathogen in controls. The result of this study suggests that bacteriuria is prevalent among elderly men in some pathological conditions such as Prostatitis. This may be caused by inflammation of prostate leading to non secretion of prostatic fluid which is bactericidal.

Key word: Prostatitis, asymptomatic, bacteriuria, uropathogen.

International Journal of Urology and Nephrology ISSN 2091-1254 Vol. 5 (2), pp. 140-144, February, 2017. © International Scholars Journals

Full length Research Paper

Assessment of Demodex spp. in perinea regions and faces of young men visiting the urology policlinic

¹Demirel Selma, ²Ömer Zeki and ²Deniz Bostancı

¹Department of Urology, Faculty of Medicine, Istanbul Sabahattin Zaim University, Halkalı, Istanbul, Turkey.

²Department of Nutrition and Dietetics, Faculty of Health Care, Istanbul Sabahattin Zaim University, Halkalı, Istanbul, Turkey.

*Corresponding author. E-mail: [email protected].

Accepted 05 November,  2016

Abstract

It has been reported that types of Demodex can be transmitted to other people through close contact and they can play a pathogenic role in rosacea, acne vulgaris, perioral dermatitis, seborrhoeic dermatitis, micropapillary-pruritic dermatitis, and blepharitis. Types of Demodex are reported to be located in various places of human body. The purpose of the present study was to detect the presence of Demodex spp. in the samples taken from the faces and perinea areas of the young men using standardized surface skin biopsy (SSSB). Accordingly, samples were obtained using SSSB method from the faces and perinea areas of 200 men aged 19 - 34, which were then covered with entellan and sent to the parasitological laboratory. Demodex spp. was found in 42.0% of the samples taken from perinea area and in 83.0% of the samples taken from subjects’ faces, while Enterobius vermicularis was detected in two cases. One of the samples taken from was Demodex brevis, while the others were Demodex folliculorum. It was concluded that, given that species of Demodex can be found in perinea area under conditions of collective accommodation, specimens should be taken from patients consulting with pruritus or allergic reactions in order to diagnose the parasite, and treatment protocol should be planned according to the results of the analysis.

Key words: Demodex spp., facies, perinea and cheek.

International Journal of Urology and Nephrology ISSN 2091-1254 Vol. 5 (3), pp. 156-164, March, 2017. © International Scholars Journals

Full Length Research Paper

Evaluation of ultrasonic ureteral lithotripsy in the management of distal ureteric stones; single center experience

Salah Shebl Zeidan

Lecturer of Urology, Faculty of Medicine for Girls – Alzahraa University Hospital – Al-Azhar University.

Email: [email protected]; [email protected].

Accepted 27 January, 2017

Abstract

To prospectively evaluate the outcome (safety, efficacy and complications) of ultrasonic lithotripsy aided by anti-migration tools and forceps in a management of distal ureteric stones. The study was conducted between October 2014 and October 2016 at urology department Al-Azhar University. A total of 70 patients with distal ureteric stones were selected. The mean Age was 43 (22 to 68) years. All underwent semi rigid ureteroscopy with ultrasonic lithotripsy in stone size ≤1.5 cm. Operative and postoperative data were evaluated and statistically analyzed.  Fragmentation time was 85.2±50.2 minutes (fragmentation time was increased in stones with increased HU). Early (day after the operation) and delayed (one month later) stone free rates were estimated. Stone free rates for ureteroscopy using ultrasonic lithotripsy were 67/70 (95.7%). Three cases with residual (4.3 %) were extracted during JJ stent removal. Three stones have retrograde migration into dilated upper urinary tract 4.3% (clinically insignificant). Auxiliary procedure performed 50 cases (71.4 %), stone basket 28 cases (40%) used to clear stones after fragmentations and preventing migration of stones. No significant intraoperative or postoperative complications were encountered. Only minor complications as fever, mucosal abrasions and mild hematuria occurred. Postoperative stenting was JJ stent in 36 cases (51.4 %) and ureteric catheter 34 cases (48.6%). One case required second setting due to probe breakdown. Our study suggests that ultrasonic ureteric lithotripsy is safe and effective without significant complications in management of distal ureteric stones.

Keywords: Ureteric stones, ultrasonic, lithotripsy, intracorpreal, ureteroscopy.