Correlation of prostate volume with international prostate symptom score and quality of life in men with benign prostatic hyperplasia.

The aim of this study was to correlate the prostate volume with international prostate symptom score (IPSS) and quality of life (QOL). Hundred consecutive patients diagnosed as having benign prostatic hyperplasia were included. All patients were interviewed using standardized questionnaires for International Prostate Symptom Score, which include one single disease-specific quality of life question. Transabdominal ultrasonogram was used to assess the prostatic volume. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age and median duration of symptom was 67.5 years and 12.0 months respectively. The mean volume of prostate was 42.5 cm3. Most of the patients had severe symptoms with mean IPSS of 23.5 and single disease-specific QOL score of 5.2. The correlation between the prostate volume and age, IPSS, and QOL score were not statistically significant except for two domains; incomplete emptying and nocturia that appear to be correlated with prostate volume. The correlation between IPSS and QOL score was strong. Similarly, correlation between QOL score and age was significant but weak. In conclusion, prostate volume had no correlation with age, symptom score, and quality of life score. So prostatic size should not be an only and important consideration; moreover, we should assess the impact of symptoms while treating the cases.

Leptospirosis and Weil's disease in eastern India.

Leptospirosis is characterised by a broad spectrum of clinical manifestations varying from inapparent infection to fulminant fatal disease. Severe leptospirosis characterised by profound jaundice is referred to as Weil's disease. In the present study 20 patients of leptospirosis, of which 7 belonged to Weil's disease, were diagnosed based on the demonstration of IgM antileptospira antibody and supported by clinical correlation and appropriate biochemical markers. Overall, the male and female ratio was 17:3 and the same ratio for the Weil's disease was 6:1. The most common presentation involved fever, malaise and myalgia. Conjunctival congestion was found in 75% of the cases and jaundice was encountered in 90% of the cases. The prognosis of all these patients, including that of Weil's disease was excellent. Early recognition and initiation of antibiotic therapy were found to be important.

Kawasaki disease--Indian perspective.

Kawasaki disease is a syndrome of unknown etiology affecting children below 5 years of age and is a leading cause of acquired heart disease in many developed countries. Incidence of this disease in India is extremely low as evidenced by the meagre case reports. Complications due to this disease in Indian patients are still rarer. Here we report two cases of Kawasaki disease both of whom had a benign course. A comparison of this disease in Indian and Western literature shows that the incidence of cardiac complications in the Indian patients is about 10% while in the west it is reported at around 30%. This paucity of complications in the Indian patients may be the reason of poor reporting of this disease in our country.

Effect of vasodilator therapy on mortality in chronic congestive heart failure.

We compared the effects of Hydralazine and Isosorbide dinitrate (ISDN) with those of an angiotensin-converting-enzyme inhibitor, captopril on mortality in patients with chronic congestive heart failure (NYHA class III and IV). Patients receiving conventional treatment with digoxin and diuretics were randomly assigned to receive either placebo (n = 51), hydralazine-ISDN. (n = 50) or captopril (n = 52) in a double blind trial. At the end of 6 months there were 14 deaths in the placebo group (27.4%) as compared with 11 deaths in the hydralazine-ISDN group (22%)--a mortality reduction of 20% (P > 0.05) and 10 deaths in the captopril group (19.2%)--a mortality reduction of 30% (p > 0.05). At the end of one year, mortality was 50%, 42% and 30% in the placebo, hydralazine-ISDN and captopril groups respectively with a mortality reduction of 16% in the hydralazine-ISDN group (p > 0.05) and 40% in the captopril group (p < 0.05) compared to the placebo group. The mortality reduction was mainly due to reduction in deaths attributed to progressive heart failure. The data suggests that the addition of captopril to conventional treatment significantly reduces mortality in patients with severe congestive heart failure. Hydralazine-isorobide dinitrate also reduced mortality but statistically this was not significant.

Evaluation of vaccination coverage.

The cluster sampling methodology based on WHO module on "Evaluate Vaccination Coverage" recommended by Ministry of Health and Family Welfare, Government of India, 1987 was followed to evaluate the vaccination coverage of eligibles. Out of the 215 eligible children between 12-23 months of age, 44.65 38.61 and 16.74 per cent were found to be fully, partially and unimmunized respectively. The dropout rate for OPV and DPT was 21.23 while it was 4.03 per cent for TT. Based on the studied facts responsible for non or partial immunization, suggestions have been made to accelerate the coverage and reduce the dropout rate.

Evaluation of nutritional and immunization services in a tribal ICDS block of Rajasthan.

The evaluation of nutritional and immunization services was undertaken in the tribal ICDS block Kherwara (Rajasthan) by comparing the results of door to door surveys conducted on pretested schedules in six randomly selected Anganwadi Villages at the start (1983) and after completion of 4 years of the project (1987). A significant improvement (p less than 0.001) was found in nutritional status of children below 6 years of age. Except for BCG, the study revealed improved vaccination coverage. However, the achievements were far less than the targets laid under the National Health Policy. Concerted efforts are required to improve the services further for achieving the desired goals.

Under utilization of MCH services--the major factor for very high IMR in rural Rajasthan.

Infant mortality rate (IMR) and its relation to the utilization of health services was studied in twelve villages of ICDS block Rajsamand, Rajasthan from 1st April, 1985 to 31st March, 1986. The total number of births and infant deaths were 386 and 74, respectively during one year, computing 37.44 as birth rate and 191.70 as IMR. Neonatal deaths contributed 51.4%, the most common causes of which were septicemia (28.9%), birth asphyxia (23.6%), extreme prematurity (18.4%) and tetanus neonatorum (13.1%). The common causes of deaths in post-neonatal period were pneumonia (36.1%), diarrhea (25.0%), complications of measles (16.7%) and that of pertussis (8.3%). Extreme under utilization of preventive, promotive and curative MCH services was found to be one of the major factors for very high IMR prevailing in the region.

Determination of gestational age: comparative accuracy of different methods.

One hundred new-born infants were studied in an attempt to test the accuracy of selected methods of post-natal assessment of gestational age. The Finnstrom method using seven external characteristics was found to be relatively more accurate both in preterm and term infants. Dubowitz and Cappuro method were accurate in premature infants only. However in a limited number of post-term infants Cappuro method yielded better results. The Finnstrom method can be recommended for routine assessment of gestational age.