15 research outputs found
Improving Quality of Life during Androgen Deprivation Therapy in Prostate Adenocarcinoma Patients: Effect of Prescribed Clinic-Based Exercise Program
Get PDFContext: The mainstay of treatment of advanced prostate adenocarcinoma is androgen deprivation therapy (ADT). ADT invariably results in a progressive loss of bone density and muscle mass and diminishing cardiopulmonary and cognitive function. Exercise is beneficial as adjuvant treatment during ADT.
Aim: This study seeks to identify the benefit of prescribed exercise programs beyond routine physical activities of daily living in low‑income patients on ADT. Settings and Design: Men on ADT for 12 months who were in the remission phase of the disease were recruited for a 6 week supervised aerobic and resistive exercise program.
Subjects and Methods: The effects of the prescribed exercise on muscle strength (MS), peak expiratory flow rate ( PEFR), maximum oxygen uptake (MOU) and brief fatigue inventory (BFI) were assessed. 10R max test was deployed for MS while the modified Young Men Christian Association protocol for bicycle ergometer was used for PEFR and MOU. All measures were taken pre‑ and post‑intervention with a check for adverse events at week 3. Statistical Analysis Used: Simple frequency in SPSS version 21 was used.
Results: Only 5 of 34 recruited subjects completed the study. There was 34.0% improvement in MOU, 34.9% improvement in PEFR, 130.0% increase in exercise duration, and 29.2% reduction in reported BFI. Improvement in parameters was more among those that had lower values at recruitment. Compliance with exercise prescription was a major challenge. All participants reported improvement in activities of daily living.
Conclusions: Prescribed aerobic and resistive exercise program is beneficial during ADT for prostate adenocarcinoma. Those with poorer reserves tend to benefit more.
Keywords: Androgen deprivation therapy, muscle strength, peak exploratory flow rate, prescribed exercise, prostate adenocarcinom
Reducing the burden of regular indwelling urinary catheter changes in the catheter clinics: the opinion of patients and relatives on the practice of self-catheterization
Get PDFBACKGROUND: Clean intermittent self-catheterization is accepted worldwide as a standard of care for patients with long-standing need for urinary bladder decompression. Evidence of its routine practice in our low-resource setting is lacking, leading to increasing number of patients with a long-standing indwelling urinary catheter. OBJECTIVE: To seek the opinion of patients already using indwelling catheters regarding the practice of self-catheterization. PATIENTS AND METHODS: Over a 4-month period, the opinion of every patient and patient’s relative that attended the regular urinary catheter clinic was sought using an intern-administered questionnaire. The data was analyzed using SPSS version 20. RESULTS: A total of 108 patients completed the questionnaire. Age range was 16–100 years with a mean of 62.2±15.5 years. Only 30.5% of the patients had formal education beyond the primary level. The median cost for change of the indwelling catheter was 1,325 naira (3.13–$25 USD). Analysis showed that: 70.8% of patients aged under 60 years/60.6% of those with formal education beyond primary level/61.9% of those wearing catheters for <3 months would give consent for training in self-catheterization. Higher cost of catheter change did not influence the decision to consider self-catheterization. Of the 59 patient relatives who completed the questionnaire, 63% of those younger than 50 years old and 69.2% of those with tertiary education would be willing to undertake training to administer self-catheterization. CONCLUSION: A select group of patients and accompanying relatives in our low-resource setting are willing to learn and practice self-catheterization
Paratesticular myxoid liposarcoma in a 23-year old Nigerian
Get PDFParatesticular liposarcomas are rare tumors and are usually seen in patients in middle age or older. Optimal treatment is radical orchidectomy. Radiotherapy or chemotherapy is added for advanced disease or recurrences. These practice guidelines often vary from the experience in developing countries
A cost effective analysis of fixed-dose combination of dutasteride and tamsulosin compared with dutasteride monotherapy for benign prostatic hyperplasia in Nigeria: a middle income perspective; using an interactive Markov model
Full text linkLower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system
No full textAbstract
Background
The point at which men seek medical care for lower urinary tract symptoms (LUTS) varies between individuals. Presentation to hospital with complications beyond LUTS appears prevalent in our setting. The aim of this survey is to assess from the community perspective in southeast Nigeria, the challenges to early presentation for medical evaluation for LUTS by men.
Methods
A questionnaire-based cross-sectional survey of randomly-selected men ≥40 years. The questionnaire captured respondent’s age; presence, duration and severity of LUTS; access to health information; wealth-index; and when (and why) medical care for LUTS was sought. Analysis was with SPSS® version 20.
Results
In all, responses from 1319 men (mean age 54.2 ± 10.2 years) are analysed. Of these, 267 report LUTS: 58.4% (156) report moderate to severe LUTS and 51.7% (138) are yet to seek medical care. As regards seeking medical care, all the men reporting LUTS of 3 months, 35.7% of 126 men reporting moderate LUTS, and 20.0% of 30 men reporting severe LUTS are yet to seek medical care. LUTS being non-bothersome (not financial constraint) is the most prevalent reason for not seeking medical care early. Delay is encouraged by limited access to health information (OR 3.10; p < 0.001), but discouraged by literacy (OR 0.86; p < 0.001) and aging (OR 0.93; p = 0.002).
Conclusion
From the community perspective, the prevalent challenge to seeking medical care for LUTS early is absence of bother. Empowering men through formal education and researched health information will influence positively the time that LUTS in men is appreciated as bothersome.
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Erectile Function in Men Presenting with Lower Urinary Tract Symptoms from Benign Prostate Enlargement: Association with Quality of Life Scores in the Context of Interviewer-Assisted Questionnaire Administration
No full textBackground:
Interviewer-assisted administration of International Prostate Symptoms Score (IPSS) and Internal Index of Erectile Function-5 (IIEF-5) questionnaires in men with lower urinary tract symptoms (LUTS) due to benign prostate enlargement (BPE) may generate inconsistent outcomes.
Objectives:
To assess the correlation between the scores from interviewer-assisted administration of the IPSS questionnaire and the IIEF-5 questionnaire in men with uncomplicated LUTS due to BPE.
Materials and Methods:
The IPPS and the IIEF-5 questionnaires were administered with interviewer assistance to a cross-section of men presenting to the hospital with symptoms of LUTS due to uncomplicated BPE. The demographics were ascertained, and the association between IPPS and IIEF-5 scores was determined using linear correlation.
Results:
There were 211 participants in 18 months with a mean age of 66.5 ± 9.5years. The mean prostate volume, prostate-specific antigen, peak flow rate, and post-void residual volume were 55.2 ± 10.1 mL, 3.1 ± 0.7 ng/mL, 20.8 ± 8.2 mL/s, and 38.1 ± 21.5 mL, respectively. One hundred and eighty-six participants (88.2%) attained post-primary level of formal education. Moderate LUTS was reported in 51.7% (n = 109), while severe LUTS was reported in 10.4% (n = 22) participants. The mean storage LUTS (sLUTS) score was 6.25 ± 2.84, the mean voiding LUTS (vLUTS) score was 4.27 ± 4.56, and the mean IPSS was 10.38 ± 6.44. The mean IIEF-5 score was 15.17 ± 6.09. There was a poor correlation between IIEF-5 and sLUTS (Spearman rho –0.02; P = 0.77), vLUTS (Spearman rho –0.058; P = 0.403), IPSS scores (Spearman rho –0.048; P = 0.49), as well as with quality of life (QoL) preferences (F 1.722; P = 0.117).
Conclusions:
Interviewer-assisted IIEF-5 scores do not relate with sLUTS, vLUTS IPSS, and QoL due to LUTS, as is the case with reports on self-administered IIEF-5 scores
Fournier’s gangrene: a retrospective review of management outcomes and seasonal variations of clinical presentation
No full textAbstract
Background
To review retrospectively the outcomes of management of Fournier’s gangrene (FG) and to assess for possible seasonal variations in clinical presentations of FG to a referral hospital in a tropical African country.
Methods
The medical records of patients who presented with FG from February 2012 to December 2019 were reviewed. Of interest were age of patient, vital signs at presentation, site of gangrene, duration of hospital admission, and management interventions deployed. Analysis was with SPSS® version 21.
Results
Twenty-three of 28 medical records could be analyzed. Median Fournier’s Gangrene Severity Index (FGSI) was 5 (IQR:3–10), the median Uludag-FGSI (UFGSI) was 7 (IQR:4–14). In 82.6%, the scrotum was the site of onset; in 8.7%, the lesion had spread beyond the pelvis. Diabetes mellitus (30.4%), HIV infection (13.0%) and nephropathy (17.4%) were identified co-morbidities. There were 2.4 ± 1.0 debridement sessions and 1.5 ± 1.3 transfused units of blood per patient. In 60.9%, the wound edges were undermined and apposed; in 17.4%, split skin grafting or fascio-cutaneous flap cover was deployed. In 17.4%, satisfactory wound closure needed more than 1 theater session. Mean duration of hospital admission was 51.4 ± 19.4 days. No mortality was recorded.
Majority (91.2%) presented in hot, dry months of October through March with peak in December. No case presented in the wet months of May through September.
Conclusion
Meager resources notwithstanding, FG management outcomes are generally satisfactory. Furthermore, FG is observed to present mostly in the hot, dry months of the year in the 8Â years under review.
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Prostate Cancer Detected by Screening in a Semi Urban Community in Southeast Nigeria: Correlations and Associations between Anthropometric Measurements and Prostate‑specific Antigen
Get PDFContext: Prostate cancer (PCa) is frequently diagnosed at advanced stages in Nigeria.Aims: To determine the screen detected PCa prevalence in a suburban community and explore any relationships between prostate‑specific antigen (PSA) and anthropometric measurements.Settings and Design: Nsukka is a town and local government area (LGA) in  Southeast Nigeria in Enugu State. Towns that share a common border with Nsukka are Edem Ani, Alor‑uno, Opi, Orba, and Ede‑Oballa. Nsukka LGA has an area of 1810 km² and a population of 309,633 at the 2006 census. All consecutive responders who met the inclusion criteria were recruited. Subjects and Methods: A screening outreach was conducted in one location in Nsukka. PSA testing and digital rectal examinations were performed. Height and weight were measured and body mass index (BMI) was calculated. Statistical Analysis Used: Results were subjected to statistical analysis using SPSS 20 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY, USA). Categorical data were analyzed using the Chi‑square test, with significance level set at P < 0.05. Pearson’s correlation was conducted for interval data (P < 0.05).Results: One‑hundred and sixty men met the inclusion criteria and were screened. Age range was 40–81 years; PSA range was 1.20–33.9 ng/ml. Digital rectal examinations (DREs) was abnormal in 17 men. Median BMI was 27.49. A Pearson’s correlation coefficient showed a significant correlation between age and PSA, r = 0.127; P ≤ 0.05, and DRE findings and PSA, r = 0.178; P ≤ 0.05. There was no significant correlation between height and PSA, r = −0.99; P = 0.211; weight and PSA, r = −0. 81 P = 0.308; and BMI and PSA, r = −0.066; P = 0.407. 8/21 men consented to prostate biopsy with three positive, giving a screen detected PCa prevalence of 1.875%.Conclusions: Screen detected PCa prevalence in high this population and efforts to improve early detection may be of value in improving treatment outcomes.Keywords: Body mass index, Nigeria, prostate cancer, prostate‑specific antigen,scree
Comparing complications of urethral stricture across various ages: a retrospective analysis of findings from retrograde urethrogram and voiding cysto-urethrogram over 10 years
No full textAbstract
Objective
To determine the rate and the distribution of the structural defects in the urinary bladder complicating urethral stricture in men, and to compare the complications observed in the younger patients to those observed in the older patients.
Methods
Retrospectively, case files of patients diagnosed of urethral stricture using retrograde urethrogram (RUG) and voiding cysto-urethrogram (VCUG) from February 2009 to August 2018 were analyzed. Stricture characteristics were outlined. In addition, complicating structural defects in the lower urinary tract proximal to the stricture site were documented. The complicating defects identified in the patients were segregated according to age for any observable associations. Logistic regression analysis was used to define the nature of the association of patient age, stricture site, number and length, with distribution of complicating structural defects. Analyses were done using SPSS® version 20.
Results
Within the 10-year review period, 257 of 421 suspected cases of urethral stricture were confirmed. Patients are between 1 and 104 years of age (mean: 50.1 ± 19.1 years; median: 51.0 years IQR 35.0–65.0). Bulbar (34.2%); short segment (62.6%); partial (73.9%) strictures are prevalent. Forty-seven (18.3%) of 257 patients presented with 1 or more complications. Bladder diverticulum (8.6%) and urethra-cutaneous fistula (6.6%) are prevalent complications. The distribution of complications does not vary with age, or with stricture characteristics.
Conclusion
Presentation with complications is not uncommon. The distribution of these complications does not vary with age or with stricture characteristics.
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The relationship between prevalence and severity of lower urinary tract symptoms (LUTS), and body mass index and mid-abdominal circumference in men in a resource-poor community in Southeast Nigeria: a cross-sectional survey
No full textAbstract Background There is paucity of information on the community-based prevalence and severity of lower urinary tract symptoms (LUTS) in men who are 40 years and older in the southeast region of Nigeria. This study seeks to determine the community-based prevalence of LUTS and the relationship between LUTS, and body mass index (BMI) and mid-abdominal circumference (MAC) in men. Methods An interviewer-administered, questionnaire-based survey. Three of nine settlement clusters were randomly selected while systematic random sampling of 1 in 3 eligible subjects was used to select participants. Analysis was done using SPSS® version 20. Results One thousand three hundred and nineteen duly completed questionnaires were analyzed. The respondents are within ages 40-92 years with mean age 54.2 ± 10.2 years, mean BMI 25.97 ± 4.18Kg/m2 and mean MAC 89.80 ± 12.43 cm. Overall prevalence of LUTS is 20.2%. Nocturia at a prevalence of 19.2% is the most prevalent lower urinary tract symptom and also the earliest to manifest. LUTS prevalence and severity increases with increasing age. About 9.6% report moderate LUTS while 2.3% report severe LUTS. Storage LUTS are reported more frequently than voiding LUTS. LUTS did not vary significantly with BMI, MAC or Wealth-Index. Conclusion LUTS prevalence and severity vary with age, but not with BMI, MAC or Wealth-Index
