Global Journal of Urology and Nephrology

Review Article of Global Journal of Urology and Nephrology Impact of components of metabolic syndrome on the prostatic volume and lower urinary tract symptoms in a sample of patient with benign prostatic hyperplasia in Iraq Dr. Alaa Al-Deen Al-Dabbagh1*, Dr. Ali Zuhair Khudhur2 1Assistant professor at Al-Mustansiriyah University/College of Medicine/Department of surgery /Baghdad / Iraq. 2Al-Yarmouk Teaching Hospital/Department of urology/Baghdad/Iraq. Objective To evaluate the  association between the components of metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH)  focusing at their effects on  prostatic volume   and on the severity of LUTS   . Patients & Methods From October 2016 to January 2018, eighty patients presented with LUTS due to the BPH. LUTS were assessed using the international prostatic symptoms score (IPSS) and MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III guidelines. Patients were randomly collected into two categories: A (48 patients) had MetS and B (32 patients) without MetS. Results The mean age was 64.3 years, statistically significant variation was identified between the two categories regarding the moderate and severe IPSS, S.PSA, prostatic size and post voiding residue (PVR),  the P value (<0.05). The most frequent MetS components were: hypertension in 65/80 patients (81.25%), high fasting glucose in 49/80 patients (61, 25%), and waist circumference elevation in 55/80 patients (68.75%). The association between MetS components, the prostatic volume   and severity of LUTS had shown that all MetS components except HDL-cholesterol were significantly correlated with higher prostatic volume (P < 0.05). Also a positive statistically significant association was discovered between each component of MetS and higher IPSS, excepting HDL-cholesterol (P = 0.93) and triglyceride (P = 0.58). Conclusion The results of the present study confirmed that there is a significant relation between the components of metabolic syndrome, the increase in prostatic ...

Review Article of Global Journal of Urology and Nephrology Lifestyle Issues and Prevention of Recurrent UTIs Abdul Kader Mohiuddin Department of Pharmacy, World University of Bangladesh, 151/8, Green Road, Dhanmondi, Dhaka – 1205, Bangladesh UTI is one of the most prevalent diseases with diverse etiological agents annually affecting 250 million and causes death of 150 million people worldwide [1,2]. Adult women are 30 times more likely than men to develop a UTI [3]. Although the estimated mortality rate is generally lower than with RTIs, it may rise up to 26% if complicated with bacteremia or septic shock [4]. Financial burden of UTIs exceeds $3.5 billion in US alone [5] whereas more than 50% of the antibiotics prescribed for a suspected UTI in older adults being considered unnecessary [6]. More interestingly, nosocomial UTIs account for nearly 40% of all hospital acquired infections [7] and around 50% of UTI in children are missed [8]. Recurrent UTIs (RUTIs) are mostly caused by frequent sexual intercourse, heterosexual lack of circumcision receptive anal intercourse (without a condom), multiple sexual partners (each sex partner shares his/her UGT microbiota with the other), use of spermicide and a new sexual partner, sexual intercourse with addicted partners, sexual intercourse with sex workers, sexual intercourse with online dating friends, sexual intercourse with a new sex partner within less than 2 months [9-20]. Traditional lifestyle factors such as fluid intake and diet are not considered independent risk factors now [15]. UTIs account for nearly 25% of all infections [16]. Sexual intercourse ≥3 times/week was associated with greater frequency of UTI [21]. Close proximity of the urethral meatus to the anus and shorter urethra, is a likely factor [22-26]. Many other factors have been thought to predispose women to RUTIs, such as voiding patterns pre- and post-coitus, wiping technique, wearing tight undergarments, ...

Review Article of Global Journal of Urology and Nephrology Alternative Management of Uncomplicated UTIs in Women Abdul Kader Mohiuddin Department of Pharmacy, World University of Bangladesh, 151/8, Green Road, Dhanmondi, Dhaka – 1205, Bangladesh UTIs typically cause women to have a severe urge to urinate, and to do so frequently. It’s also often very painful when they do, and many experiences a burning sensation in their bladder or urethra. Two common factors emerged in urine that had a better ability to resist bacterial growth: it had a high pH—one that’s more alkaline, in other words—and higher levels of certain metabolites formed by gut microbes. Physicians already know how to raise urinary pH with things like calcium supplements, and alkalizing agents are already used in the U.K. as over-the-counter UTI treatments. However, early on in an infection, cells produce a protein called siderocalin that blocks bacterial growth, including the growth of E. coli. Uncomplicated UTIs usually go away with drugs within two to three weeks, but in some cases, women may take antibiotics for 6 months or longer if their UTIs keep coming back. Most UTIs are caused by the bacteria Escherichia coli (E. coli), and recent surveillance data shows a significant rise in cases of UTIs caused by E. coli that are resistant to the antibiotics most commonly used to that treat them. Doctors say “It’s uncomfortable but not life-threatening, so women don’t go in”. Keywords: Escherichia coli, cystitis, recurrent UTIs; bacterial biofilm; fluid consumption; essential oil ...

Case Report of Global Journal of Urology and Nephrology Turning complexity into clarity: polyuria and hypernatremia Awad Magbri, MD, FACP, Shaukat Rashid, MD Surgery and Vascular Center at Regency Park, LLC, Toledo, OH Case history The patient is 65-year old African American male with history of hypertension. He was admitted to hospital with lethargy, disorientation, and confusion. His clinical evaluation and CT of the head revealed subarachnoid hemorrhage. He had h/o stroke 5 years ago. The patient didn’t have fever, but did have a diarrhea of 1-day duration. He is receiving parenteral feeding and his urine output is 4L/day. His physical examination revealed blood pressure of 100/70mmHg, with heart rate of 100 BPM. He has dry mucous membranes and the rest of examination was unremarkable. His laboratory investigation showed sodium 159meg/L, K+ 4.6meg/L, chloride 114mEq/L, HCO3 26mEq/L, creatinine 1.9mg/L, Blood urea nitrogen 64mg/L, and glucose 200mg/L His urine sodium 70mEq/L, and urine osmolality 380mOsm/Kg H2O. His volume status is slightly dry, and he weighs 70Kg. Case discussion This case illustrated several information including polyuria with parenteral nutrition, low blood pressure and dry mucous membranes denoting low extracellular fluids volume. High serum sodium, and high urine osmolality in the face of hypovolemia and hypernatremia. As a consequence of his illness he suffered from low perfusion to the kidneys with worsening kidney function. Hypernatremia is a common electrolyte abnormality and defined as a serum sodium >145mEq/L (1,2,3). Hypernatremia is hyperosmolar state caused by a decrease in total body water (TBW), relative to electrolytes content (4). Therefore, hypernatremia is a water problem not sodium problem. It often occurs in elderly and hospitalized patients with restricted access to water and in those with impaired thirst mechanism (hypodipsia/adepsia) or mental status changes. Developing hypernatremia is virtually impossible if the thirst mechanism is intact and water ...