Overactive bladder: A multicenter study in Pakistan.

OBJECTIVE: To determine the overall prevalence of overactive bladder in Pakistan, and to determine the difference in prevalence in relation to gender. METHODS: The multicenter study was conducted from February 2017 to October 2018 at 11 institutions across the country, and comprised randomly selected healthy subjects of either gender who were assessed on the basis of symptoms defined by the International Continence Society for overactive bladder. Data was collected using a questionnaire based on the symptoms which was filled for the respondent by designated health workers. Data was analysed using SPSS 23. RESULTS: Of the 1291 respondents, 632(49%) were males with a mean age of 37.8±14.4 years, and 659(51%) were females with a mean age of 38.3±13.7 years. The overall prevalence of overactive bladder was 82(6.4%). Among the males, it was 15(2.4%) and among the females 67(10.2%) (p=0.001). Urgency, frequency and nocturia were reported by 82(6.4%) respondents; 15(1.2%) males and 67(5.2%) females (p=0.001). CONCLUSIONS: The prevalence of overactive bladder was found to be low when assessed with strict application.

Spontaneous splenic rupture: case report and review of literature.

Splenic rupture is a potentially life-threatening condition, often associated with chest or abdominal trauma. Spontaneous rupture is very rare and is usually reported as being secondary to underlying pathological conditions. We report a case of atraumatic splenic rupture in a patient with no underlying disease pathology. This case should remind the emergency physician spontaneous splenic rupture should be considered in the differential diagnosis of unexplained acute abdominal pain.

Should we use the shorter Thai-version quality of life and symptoms questionnaires in women with overactive bladder?

AIM: The aim of this study was to test: (i) the validation and reliability of the Thai versions of overactive bladder (OAB) questionnaires (the 8-item and 3-item Overactive Bladder Symptoms Score questionnaires [OAB-v8 and OAB-v3, respectively] and the Overactive Bladder Questionnaire [OAB-q]); and (ii) the correlation of the OAB-v8, OAB-v3, and the single-question Quality of Life Questionnaire (1-QoL) to the OAB-q in Thai women with OAB. MATERIAL AND METHODS: During January to March 2011, 36 Thai women with OAB attending a urogynecology clinic at Chulalongkorn Hospital, Bangkok, Thailand were recruited. All questionnaires were given as a psychometric test twice, 2 weeks apart. RESULTS: Cronbach's alpha of the OAB-v8 was higher (and above 0.7) than OAB-v3 at both week 0 and week 2. The intraclass correlations (ricc ) were 0.64, 0.85, and 0.97 for the OABV8, OAB-v3, and OAB-q, respectively. The correlation coefficient (r) of OAB-v3 and OAB-q at weeks 0 and 2 (0.40 and 0.49) were lower than those for OAB-v8 and OAB-q at weeks 0 and 2 (0.62 and 0.62). All questions on the OAB-v3 had a lower weighted kappa than OAB-v8. There was no statistically significant difference in the OAB-q score in each level of 1-QoL score at week 0 (P = 0.12) and at week 2 (P = 0.29). CONCLUSION: The reliability of the OAB-v3 is poorer than that of the OAB-v8. The OAB-v3 is poorer correlated to the OAB-q than to the OAB-v8. A short questionnaire, such as the OAB-v3 and the 1-QoL, has poor reliability and is poorly correlated to the OAB-q and is not recommended as a replacement for the standard questionnaires, such as the OAB-q and the OAB-v8. The OAB-v3 should only be used in large screening populations where there are time limits.

Calcified liver hydatid cyst compressing the gall bladder.

A 48-year-old male patient was admitted to suffering from hydatid disease located in the gall bladder. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease was rare. The pericyst was tightly attached to the liver. Complete pericystectomy with cholecystectomy was done. Histopathology confirmed the presence of a calcified hydatid cyst of the gall bladder. Perioperative adjuvant medical therapy with albendazole was administered. After a 2-year follow-up, no recurrence occurred.

Tuberculous appendicitis.

Gastrointestinal tuberculosis is quite rare, representing only 3% of all extrapulmonary cases. Involvement of the appendix is rare, only occurring in about 1% of cases. It is usually secondary to tuberculosis elsewhere in the abdomen. A prompt diagnosis depends on a high index of suspicion as clinical signs may be nonspecific and microbiological confirmation is difficult. Histopathologic examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed until after surgery.

Primary anal mucinous adenocarcinoma: a case series.

Primary mucinous adenocarcinoma is a rare malignancy of the anus (3% of anal cancers), the pathogenesis of which is better understood by immunohistochemistry. We reviewed cases of primary mucinous adenocarcinoma of the anus from 2000 to 2009 in the Hepatogastroenterology Department of the University Hospital Centre of Marrakech. Three cases were identified who were males with the mean age of 68years, and presented with a chronic anal fistula. Two cases had anal pain. Clinical examination revealed multiple fistulae in two cases with a secretion simulating 'cooked grains of tapioca'. Diagnosis was confirmed by histopathology and immunohistochemical profile (CK7 positive/CK20 negative). Imaging revealed a retro-rectal collection with thickening of the anal wall without metastasis (two cases). One patient underwent abdominoperinal resection without recurrence.