Success rate and patients' satisfaction following intradetrusor dysport injection in patients with detrusor overactivity: a comparative study of idiopathic and neurogenic types of detrusor overactivity.

PURPOSE: To evaluate the efficacy of intradetrusor Dysport (a type of botulinum toxin type A) injection in patients with idiopathic or neurogenic detrusor overactivity, who were refractory to antimuscarinic drugs, and to compare the efficacy of Dysport injection in both groups. MATERIALS AND METHODS: Twelve patients with neurogenic detrusor overactivity (NDO) and 18 patients with idiopathic detrusor overactivity (IDO) participated in this study. All the patients received intravesical injection of 500 units of Dysport. They were followed up for 3 months after injection with maximum cystometric capacity, maximum detrusor filling pressure, and number of catheterization or pad usage. RESULTS: After 3 months, the mean maximum cystometric capacity increased from 109.36 ± 24.11 mL to 266.81 ± 97.18 mL (P = .000) in the NDO group and from 192.24 ± 36.21 mL to 272.61 ± 63.37 mL (P = .000) in the IDO group. The mean maximum detrusor filling pressure decreased from 48.14 ± 26.51 cmH2O to 28.91 ± 9.01 cmH2O (P = .005) in the NDO group and from 39.22 ± 9.92 cmH2O to 29.64 ± 10.14 cmH2O (P = .003) in the IDO group. CONCLUSION: Intradetrusor Dysport injection improved urodynamic parameters and quality of life (QoL) in both groups significantly. We did not find significant difference in QoL or urodynamic parameters between both groups.

Major causes of hospital admission in Beta thalassemia major patients in southern iran.

OBJECTIVE: Beta thalassemia major is a prevalent hereditary disease in Mediterranean region especially Iran. Early blood transfusion is necessary for most of the patients and frequent transfusion can cause various medical problems for the patients. The aim of this study was to find major causes of hospital admission in beta thalassemia major patients to reach the accurate preventive and therapeutic plans for these patients. METHODS: Four hundred twenty six patients were admitted to the Nemazee Hospital (the main University referral Hospital Center affiliated to Shiraz University of Medical Sciences in Fars Province, southern Iran) during 3 years period (January 2007 to January 2010). A questionnaire was filled containing age, gender, hemoglobin level, frequency of blood transfusions, deferoxamine injection, cause of hospital admission and hospital course. FINDINGS: The mean age of patients was 11.28 years. The mean serum ferritin level was 1820±749 µg/lit. Two hundred fifty five (59.75%) patients were male and 171 (40.25%) patients were female. The top five most prevalent causes of hospital admission were splenectomy (21.8%), infections (19.9%), congestive heart failure (19.0%), diabetes mellitus (13.4%), and Liver biopsy (11.5%). (P=0.0002) CONCLUSION: Results of this study revealed that infections and complications due to iron overload are major causes of hospital admission in beta thalassemia major patients.