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Introduction: Alzheimer’s disease (AD) is a degenerative disease and dementia is a neurological condition which is significantly caused by AD. Sometimes it is found at early to middle age which is associated with cognitive and functional impairment. There is no significant curative treatment till now but only symptomatic treatment in available. Aim of this study is to describe evidence-based physiotherapy management for fall prevention associated with Alzheimer’s disease. Case Report: This is a case-based study which features an elderly man who has just fallen for the few times and has early Alzheimer’s disease (AD). In literature, exercise therapy is proven to be effective for fall management. Exercise was demonstrated by the physiotherapist and follow-up was done on a regular basis. The fall prevention exercise included core muscle strength training, cue gait training, fall prevention strategy, and task-based functional activity practice focused on Alzheimer’s symptoms. The patient was assessed with the Tinetti Patient Oriented Mobility Assessment (POMA) and Berg Balance Scale score (BBS). The initial score was 8/28 for POMA and 19/56 for BBS, and after 8 weeks it was recorded as 19/28 and 21/56. Oxford muscle grading system was used for measuring strength. Conclusion: Final outcomes suggested minor improvements in balance, strength of lower limbs, functional activities. This case study focuses on the importance of physical exercise to improve balance and prevent consequences of fall.

Introduction: Benign enlargement of prostate (BEP) is one of the common problem in elderly male. Most of the patients present with lower urinary tract symptoms (LUTS) which consist of voiding symptoms and storage symptoms. Transurethral resection of prostate (TURP) is the gold standard treatment option for BEP. TURP improves both obstructive and storage symptoms in majority of cases. But sometimes storage symptoms persist after TURP. This study was done to predict the factors for persistence of storage symptoms after TURP by evaluating clinical and urodynamic variables. Objective: To predict the factors for persistence of storage symptoms after transurethral resection of prostate (TURP) by evaluating clinical and urodynamic variables. Materials and Method: This was a prospective analytic study done in the department of Urology, Bangabandhu Sheikh Mujib medical university (BSMMU), Shabagh, Dhaka. In this study, total 60 patients of BEP with the indication of TURP were enrolled. Preoperative data includes Age of the patient, International prostate symptoms score(IPSS), IPSS storage sub score, Qmax, QoL scores, Maximum cystometric capacity(MCC), Post void residue(PVR), PdetQmax, Bladder contractility index (BCI) and postoperative data includes post-operative IPSS storage sub score, Qmax were recorded and analyzed. Result: Among preoperative variables, Age (>65y) and IPSS storage sub score has highest predictive value. Bladder contractility index (BCI) and MCC have significant predictive value. Qmax and PVR have also predictive value. Conclusion: This study result shows elderly patient of higher age group, preoperative high IPSS storage sub score, smaller MCC & high BCI have chance of persistence of storage symptoms. Bangladesh J. Urol. 2021; 24(2): 135-140

Background: Nephron-sparing surgery is an accepted treatment modality for renal cell carcinoma (RCC) in certain situations. Objectives: The aim of this study was to compare perioperative outcomes after laparoscopic and open partial nephrectomy for patients with a solitary renal tumors of 7cm or less in different institutes in Dhaka. Methodology: Between June 2013 and October 2020, 23 patients had undergone LPN and 24 patients had undergone OPN for the treatment of solitary renal tumors of 7cm or less in different institutes in Dhaka. Large renal mass (>7cm), multiple tumor and patients with complex renal anatomy were excluded from this study. Patients having previous abdominal surgery were excluded from LPN and all LPN were performed transperitoneally. Results: Although the mean operative time was longer in the LPN than in the OPN group (134.4±35.36 (45-180) minutes versus 110.56±35.36 (60-165) minutes; P

Bentonite has been modified using H2SO4 at various concentrations to alter Si/Al ratio that is responsible for catalytic pyrolysis of single-use waste polyethylene (SUWP). The XRF analysis confirmed a gradual decrease of Al2O3 content with an increasing concentration of H2SO4. The highest liquid hydrocarbon yield (87.48%) was obtained at Si/Al ratio of 34.24. To further activate acid-modified bentonite, bimetals (Cu/Ni, Fe/Ni, and Co/Ni) impregnation was conducted. The catalytic performance was compared with monometals (Ru, Co, Ni, Cu, and Fe) impregnated bentonite counterparts. The Co, Ni, or Cu impregnated bentonite catalysts (with 86, 83, and 86% yield) outperformed Fe and Ru impregnated bentonite catalysts (with 68% and 79% yield). However, bimetallic (Cu/Ni, Fe/Ni and Co/Ni) catalysts enhanced severe cracking leading to the formation of more gaseous hydrocarbons and thus less amount of liquid (70–80%) is obtained. Incorporation of iron into bentonite or Ni/bentonite increased the amount of 2-Octene, 3,7-dimethyl-, (Z)- compared to acid-treated bentonite and Ni/ bentonite catalysts. Moreover, Fe/Ni/bentonite has also increased the amount of 2-Octene, 2,6-dimethyl- compounds. The BET analysis shows that both surface area and pore diameter increased due to acid treatment resulting in an increase in the percent yield of liquid compared to raw bentonite. The FTIR and GC-MS analysis confirmed that the liquid hydrocarbon consists of linear and branched alkanes and alkenes with some cyclic hydrocarbons. The NMR analysis showed the liquid hydrocarbon is free from the aromatic compounds and polycyclic aromatic hydrocarbons (PAH).

Objective: To evaluate the role of flexible cystoscopy and ultrasound together in thedetection of recurrent superficial bladder tumors Method: This hospital based prospective comparative study was carried out in theDepartment of Urology, National Institute of Kidney Diseases and Urology, Sher-E-Banglanagar, Dhaka from January 2013 to June 2014. A total of 85 patients of post transurethralresection (TUR) and post chemotherapy state for superficial bladder tumors were includedin this study. Transabdominal ultrasonography of the bladder was performed for all casesby a consultant radiologist. Flexible cystoscopy was performed by a trained urologist forall. Finally conventional rigid cystoscopy with or without biopsy was performed at thesame setting to confirmed the findings. Result:The mean age was found 62.9±9.7 years with range from 41 to 80 years. Majority(82.4%) patients were male and 15(17.6%) patients were female. Male female ratio was4.7:1. It was observed that majority (54.1%) patients was found pT1 stage and 39(45.9%)was pTa stage. It was observed that more than two third (67.1%) patients had grade-Iand 28(32.9%) had grade-II.Sensitivity, specificity, accuracy, positive and negativepredictive values of combine USG and flexible cystoscopy for identification of recurrenttumors were 92.7%, 33.3%, 90.6%, 97.4% and 14.3%. Conclusion: Ultrasonography and flexible cytoscopy together can detect recurrentsuperficial bladder tumors as accurate as conventional rigid cytoscopy. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.41-46

Objective: To determine the outcome and complications of CAPD catheter implanted by open surgical technique for peritoneal dialysis. Methods: In this prospective study peritoneal dialysis catheter (PDC) for continuous ambulatory peritoneal dialysis was inserted into the abdominal cavity using an open surgical approach. We described our experience of open surgical minimal invasive technique of CAPD catheterization from July 2012 to June 2015. Total 40 catheters were inserted successfully. Patients were followed up for a variable period of 3-36 months. Results: In this study common indications of CAPD catheter insertion were CKD-5 due to diabetic nephropathy, chronic glomerulonephritis, and hypertensive nephrosclerosis. Common catheter related complications were peritonitis, hypokalaemia, exit site infection, catheter malfunction. Late peritonitis remains the major drawback of PD treatment, with the need of temporary or permanent changeover to the HD treatment in 10% of the patients. Conclusion: Enrichment of the physician’s interest and experience, along with a multidisciplinary approach to outline the optimal strategy of PD-catheter insertion and management of complications may improve technique and patients’ survival and decrease the morbidity. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.62-67

Objective: To evaluate the association of detrusor muscular activity with outcome of TURP in patients with severity of bladder outflow obstruction. Methods: This is a hospital based cross sectional study conducted in the Department of Urology of Dhaka Medical College Hospital, Dhaka.Elderly male patients having lower urinary tract symptoms (IPSS=20-35) with no retention (non-catheterized patient), who attended in Dhaka Medical College Hospital, were included in the study. A total of 73 patients meeting the enrollment criteria were included in the study. They were evaluated by history, physical examination including DRE and necessary investigations to identify the potential candidates for TURP. Then the potential participants were counseled for Urodynamic study. All patients underwent TURP by expert surgeon. Three months after TURP, repeat Urodynamic study was done and the results were compared to see the outcome. Afterward the data were plotted for the clarification of detrusor contractility at three levels: normal detrusor contractility (voiding pressure 40-60cm of water), detrusor over activity (voiding pressure >60cm of water) and detrusor under activity (voiding pressure 40); equivocal(BOOI=20-40);Unobstructed(BOOId” 20) are taken into consideration. The test statistic used to analyze the data was descriptive statistics and ANOVA test. The level of significance was set at 0.05 and P

Objective: To evaluate the effectiveness of single dose 5 % povidone iodine renal pelvic instillation sclerotherapy for the treatment for chyluria. Methods: In a prospective study from January 2009 and till June 2013, 47 patients presenting with milky urine (chyluria and hematochyluria) were included. Patients with other co-morbid illness like diabetes, urinary infection, renal stone disease, chronic pyelonehritis were excluded from the study. Apart from ether test, the presence of lymphocytes in urine and urine triglycerides levels were also done to confirm chyluria. Under local anesthesia, cystoscopic evaluation revealed right-sided efflux in 11 (23.4%), left-sided in 36 (76.6%), and no bilateral involvement was detected. 5F open-ended ureteric catheter was introduced in the ureteric orifice of affected side. Freshly prepared 10 ml of 5 % povidone iodine solution was instilled over a minute with the patient in Trendelenburg position. Results: Total of 47 patients were enrolled (26 males and 21 females; mean age 41 years, SD 8.4, range 29–71) with a mean follow-up of 12 months. Immediate clearance was seen in all patients and recurrence in 9 (19.15 %). Overall success rate 80.85%. Mean diseasefree duration was 12 months. Three patients had moderate to severe flank pain. Conclusion: Single dose 5 % povidone iodine sclerotherapy is a effective treatment for chyluria. As the patients discharged on the next day after procedure, it can be offered as a day care basis, so continuous ureteral and urethral catheterizations can be avoided. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.74-78

Objective : To observe the improvement of the symptoms of perineal heaviness and frequency after treatment with Magnetic Infra Red Laser therapy in patients of chronic pelvic pain syndrome /Chronic Prostatitis Methods : This study was an observational study done on 30 male patients with age range varied from 30 to 60 years .The study was conducted from 2009 to 2011 in a private medical center at Dhaka city . The MIL-therapy in use has a wave length of 904 nm and a frequency of 3000 Hz. The Laser beam reaches the prostate with a special optical probe. In this study the patient is examined per rectally after doing digital rectal examination with use of gloves and gel. At the beginning we used a “Laser Super Sonic” machine with endorectal optical probe according to Strada. The treatment schedule was one treatment every two days (treatment’s time of 5/10 minutes, wave length 1000 KHz) for a total of 10 applications. After 10 applications patients were asked for follow up and data were collected and analysed. Results : Out of 30 patients of chronic pelvic pain syndrome aged between 30-60 yrs were under treatment with MIL therapy. Among them only 22 patients were with complains of perineal heaviness, 20 patients were cured and 22 patients were with complains of frequency, 20 were cured and 02 were improved after laser treatment . Among 30 cases 23 patients found normal sized prostate and 07 found enlarged prostate on digital rectal examination and on USG findings, 21 were found normal sized , 09 found enlarged sized prostate and 07 patients had increased PVR . Conclusion : Treatment with Magnetic infra red laser therapy (MIL-therapy) gives useful effect on chronic pelvic pain syndrome (CPPS). The following short article gives a very good summary of the benefits of laser therapy and totally cured of symptoms . CPPS , a painful type of Chronic Prostatitis frequently troubles man for years. Among many sign and symptoms of CPPS , like perineal heaviness and frequency were observed and found very good effect after laser therapy. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.79-82

Objective: To find out the appropriate strategies to increase the donor pool for kidney transplantation. Methodology: The PubMed literature database was searched from 2015 to 20 years backward. Strategies to increase and improve live donor KT were suggested. In order to formulate some suggestions to reach that target, related experience and strategies published in journals of last 20 years both from developed and developing countries, were reviewed. Results: Strategies to increase and improve live donor KT were suggested .Only Live donor KT can never fulfil the demand of KT. The most important step to boost up KT program is to start deceased Donor Organ Transplantation and by formulating a law and establishing infrastructure. Development of National Kidney Transplant Registry and coordination of KT at National level is also very important. Those patients who cannot afford expenditure for KT and post-transplant care, can be supported by raising fund at national and international level. Conclusion: To increase living donor KT, techniques of increased graft survival, donor and recipient comfort, confidence and safety should be established . Inclusion of both brain death (BD) and Deceased Circulatory Death (DCD) in Deceased Donor pool will be good option for increasing donor pool. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.88-93

Objectives : To evaluate complications in Intra-prostatic local Anaesthesia and Periprostatic local Anaesthesia for TRUS Guided Prostate Biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, evaluate complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Result : The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. No systemic lidocaine toxicity was observed in group II. But only dizziness were found in 2 cases (6.7%) and visual disturbance were found in 1 (3.3%) case respectively in group I. Urinary tract infection was found 2(6.7%) in group I and 1(3.3%) in group II patients. Hematuria was found 23(76.7%) in group I and 19(63.3%) in group II. Rectal bleeding was found 14(46.7%) in group I and 11(36.7%) in group II. The statistically not significant (p>0.05) between two groups in chi square and fisher exact test respectively. Conclusion : It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. Complications wer4e less in intra-prostatic local anaesthesia than periprostatic local anaesthesia for TRUS guided prostate Biopsy. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.82-86

Objective: This study is designed to observe the short-term outcomes of dorsolateral onlay urethroplasty to treat long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry

Objective: To assess the articles published on current treatments for Peyronie’s disease (PD) and it’s new development and to assist clinicians to select the effective management of PD by increasing understanding and awareness of the outcomes associated with current medical and surgical treatment options. Methods: A Hinari literature search was conducted to identify relevant, peer-reviewed, clinical and review articles published related to current treatment options and it’s new developments of Peyronie’s Disease. Search terms for this non-systematic review included ‘Peyronie’s disease’, ‘current treatment, outcomes’, new development. ‘Erectile dysfunction or ED’, search terms were searched separately and in combination. Case studies and editorials were excluded, primary manuscripts and reviews were included, and references of articles of interest were reviewed and key references were obtained. Result: Currently, there are several investigational minimally invasive and non-surgical treatment options for PD; however, surgical treatment remains the standard of care for patients with stable disease and disabling deformity or drug-resistant erectile dysfunction. Each of the different surgical procedures that are used for treatment of PD, including tunical shortening, tunical lengthening (plaque incisions or partial excision and grafting), and use of inflatable penile prostheses, carries its own advantages and disadvantages in terms of potential complications and postoperative satisfaction. No single, standard, surgical treatment for this disorder has prevailed and multiple variations of each type of procedure exist. Obtaining data on current treatment and its modifications to these procedures, and new surgical techniques and materials may serve to further guide Conclusion: The real etiology of Peyronie’s disease and the mechanisms of formation of the plaque still remain obscure. Although conservative management is obtaining a progressively larger consensus among the experts, surgical correction still remains the mainstay treatment for this condition. Treatment should be tailored to each patient after a detailed evaluation of disease severity and sexual function. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.87-96

Objective: To compare the outcomes of tubularized incised plate urethroplasty and modified tubularized incised plate urethroplasty in the primary management of distal hypospadias Materials and Methods: Total 70 patients of age group 2 to 10 years with distal hypospadias were selected for this study from January 2008 to December 2010. They were divided into Group-A (n=35) treated by the tubularized incised plate urethroplasty and Group-B (n=35) treated by the modified tubularized incised plate urethroplasty.The modification was performed by using inner preputial skin on the incised plate before tubularization. All patients were followed up immediately and at 4th, 8th and 12th weeks after operation. Results: The satisfactory cosmetic and functional outcomes were observed in 29 patients (82.85%) of Group-A and all families of Group-B were happy with aesthetic and functional outcomes. Urethrocutaneous fistula developed in 5 patients (14.70%) patients of Group- A and 1 (2.94%) patient in Group-B. Three patients (8.82%) in group-A and one patient (2.94%) in group-B were found to develop meatal stenosis. One patient (2.94%) developed stricture urethra in group A but no patient in group-B developed urethral stricture. Overall complications occurred in 10 patients (29.41%) in Group-A and 2 patients (5.88%) in Group-B. Conclusions: This study demonstrates that modified tubularized incised plate urethroplasty had excellent cosmetic and functional outcomes and fewer complications than that of tubularized incised plate urethroplasty in the primary management of distal hypospadias. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.75-81

Background: Cervical radiculopathy (CR) is one of the prevalent causes of neck pain and disability. Physiotherapy and pain medications are the common nonoperative management, and in physiotherapy, there are many concepts of assessment and management. This study aims to determine the comparative effectiveness of three specialized physiotherapy approaches or only pain medications for managing CR cases. Methods: A prospective, assessor, and participant-blind, four-arm randomized control trial (RCT) has been planned to conduct on 160 patients with chronic cervical radiculopathy in 4 specialized centers of Dhaka city recruited between July and December 2022. Four groups (n=40) will be treated through structural diagnosis and management concept (SDM), regional approaches (RA), McKenzie mechanical diagnosis and therapy (MDT) concept prescribed by advanced practice physiotherapist (APP), or pain medications prescribed by the specialist physician for 4 weeks. The outcome will be evaluated in baseline, intermediate test (14 days), and post-treatment (28 days) through Brief Pain Inventory (BPI) for pain, Goniometer reading for cervical range of motion (ROM), and Neck disability index (NDI) as the primary outcome. The secondary outcome will be quality of life measured at baseline and post-treatment by the WHO quality of life questionnaire WHOQOL-BREF. Discussion: The study will compare the efficacy of the three physiotherapy approaches with pain medications when treating chronic cervical radiculopathy. The findings will provide evidence when demining the best conservative management approach for CR. Clinical Trial Registry India: CTRI/2022/03/040922 (08/03/2022)

Not Available Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.47-48

Not Available Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.59-60

Viscous heating technology can destroy disease-causing microorganisms with no additional heat input. A laboratory-scale unit was constructed and tested with a simulant, and viscous heating achieved temperatures as high as 190°C. This study discusses additional variables – length and spacing – that are important to process design and optimization. The viscosity (μ) was described as a function of shear rate (γ̇); μ = 140 Pa s for t = 0 s and μ = 32*(γ̇)−0.6 Pa s for t > 0 s. The advantages of viscous heating to sanitize fecal mass are presented. The results show temperature gradient is more sensitive to changes in gap spacing than reactor length. For high throughput, the viscous heater length must be increased to provide fluid sufficient residence time to achieve the desired effluent temperature.

Highly viscous substances, such as feces, produce significant heat when layer deformation occurs. We describe the use of viscous heating sufficient to destroy disease-causing microorganisms and whipworms in feces. Computational fluid dynamics (CFD) was used to evaluate preliminary design and provide initial geometric specifications for a laboratory-scale unit. The laboratory device has a rotating core separated from a fixed shell wall by a defined space. Data were obtained over a range of operating conditions with simulant materials. The CFD model was validated with the experimental results. The temperature observed with the smallest spacing was 190 °C. Alternative geometries are considered for high-volume sludge processing. Potential design modifications include enhancing efficient water evaporation and recovery.