A Comparative Study of Solifenacin, Mirabegron, and Their Combination as Bladder Relaxants in the Management of Overactive Bladder.

Introduction  Overactive bladder (OAB) is a medical state that presents as the urgency of urine and increased frequency of micturition and is diagnosed on the basis of the presence of these symptoms in the absence of other explainable diagnoses. The management of this condition includes conservative management, medical management/pharmacotherapy, and surgical management. The overactive bladder has been treated with smooth muscle relaxants, but there are conflicting results. Hence, this study aimed to assess the result of the two smooth muscle relaxants, mirabegron and solifenacin, and their combination to manage an overactive bladder. Methodology  A clinical trial was conducted at Swaroop Rani Nehru Hospital, Motilal Nehru Medical College, Prayagraj, India, over the period from November 2019 to December 2020. Ninety patients with OAB were divided into three groups: G1, G2, and G3. These groups were administered solifenacin, mirabegron, and a combination of mirabegron and solifenacin (S+M), respectively. Follow-ups were conducted at 2, 4, 12, and 18 weeks for evaluation. Data were entered into IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Appropriate statistical tests, including the chi-square and ANOVA, were employed in this study. Observation  The combination of mirabegron and solifenacin was significantly more effective in terms of response compared to solifenacin alone. There was no significant difference between solifenacin versus mirabegron, or between mirabegron (M) and the combination of mirabegron (M) and solifenacin (S). Side effects were more severe in patients taking high doses of solifenacin. Conclusion  The S + M combination has higher efficacy than solifenacin and mirabegron when given alone.

Various Modalities of the Resurfacing of the Lower Limb and Its Outcome.

Introduction With a better understanding of local fasciocutaneous flaps, local muscle flaps, split skin grafts, myocutaneous flaps, cross-leg flaps, and microvascular free tissue transfers, soft tissue management has improved during the past few years. The present study was conducted to study the various modalities of resurfacing lower extremity wound defect and their clinical outcome in patients with lower extremities trauma. Methodology An observational study was done in the Department of Plastic Surgery at Baba Raghav Das (BRD) Medical College, Gorakhpur (UP), and Maharshi Vashishtha Autonomous State (MVAS) Medical College, Basti (UP), with 30 patients admitted for lower limb resurfacing irrespective of the cause of wound defect from December 2020 to November 2021. Age, comorbidities, wound features, surgical techniques, postoperative outcomes, and complications were all recorded from the patients' case sheets. Results All 30 patients in our study underwent some or other form of soft tissue cover suturing or healing with secondary intention or skin graft or flap cover. The majority of the patients underwent debridement and skin graft (70.0%). Flaps were used in the exposed tibia/joint/flexor surface of the limb. The donor area in all the cases was skin grafted. Conclusion Trauma and burns are the most common causes of soft tissue defects in the lower extremity. The major goal of the patient's treatment is to achieve rapid functional results and lesser cosmetic restoration, while using the least-invasive treatment procedure possible. The use of free flap is decreasing, while the use of local flap is increasing. However, it should be kept in mind that some procedures used to preserve function may not have the best long-term effects, and, in some instances, amputation may be required.