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Barrantes Murillo DF, Henriksson A, Neto RALLT. A 2-month partial colorectal obstruction, tenesmus, and hematochezia in a dog. J Am Vet Med Assoc 2024:1-4. [PMID: 38520749 DOI: 10.2460/javma.24.01.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/26/2024] [Indexed: 03/25/2024]
Affiliation(s)
| | - Andrea Henriksson
- 2Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
- 3Canada West Veterinary Specialists, Vancouver, BC, Canada
| | - Rachel A L L T Neto
- 1Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL
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Szabo Z, Moser J, Vincenti S. Persistent mullerian duct syndrome in a dog. SCHWEIZ ARCH TIERH 2023; 165:189-0. [PMID: 36852872 DOI: 10.17236/sat00389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION This case report describes a 14-year-old, male castrated York Shire Terrier, which was presented due to stranguria and tenesmus. An abdominal computed tomography (CT) scan raised a high suspicion of a persistent mullerian duct. During laparotomy structures were found that were suspected to be a persistent ovary and uterus. The abnormal uterus was filled with fluid and had a blind end on both sides. The abnormal structures were surgically removed and pathologically examined. Pathology confirmed a persistent mullerian duct. The patient recovered well from the surgery and was able to urinate spontaneously the same day and was discharged the next day.
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Affiliation(s)
- Z Szabo
- Abteilung Chirurgie, Departement für Kleintiere, Vetsuisse Fakultät, Universität Bern
| | - J Moser
- Freelance Veterinarian, Schweiz
| | - S Vincenti
- Abteilung Chirurgie, Departement für Kleintiere, Vetsuisse Fakultät, Universität Bern
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Ali R, Irfan M, Akram U, Vaince M, Hassan K, Maqsood A, Aslam A, Amaan N, Qamar A, Memon S. Efficacy of Natural Formulation Containing Activated Charcoal, Calcium Sennosides, Peppermint Oil, Fennel Oil, Rhubarb Extract, and Purified Sulfur (Nucarb®) in Relieving Constipation. Cureus 2021; 13:e18419. [PMID: 34725578 PMCID: PMC8555919 DOI: 10.7759/cureus.18419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Long-term use of laxatives may have side effects such as bloating, allergic reaction, abdominal pain, metabolic disturbances, and hepatotoxicity. In this study, we have compared the efficacy of herbal medicine Nucarb, a combination of activated charcoal, calcium sennosides, peppermint oil, fennel oil, rhubarb extract, and purified sulfur, in relieving constipation. Methods This longitudinal study was conducted in multiple cities of Pakistan from April 2021 to June 2021. A total of 1000 patients, of either gender between age group 18 and 75 years, with complete spontaneous bowel movement of less than or equal to two times per week, were enrolled in the study. Participants were prescribed two tablets of Nucarb once daily (OD) at bedtime for the first seven days, followed by one tablet of Nucarb OD at bedtime for the following seven days. They were asked to return for follow-up after 14 days. Results There was a statistically significant improvement in all six components of constipation. After 14 days, the severity of constipation reduced by 80.70%, the sensation of straining was reduced by 72.69%, and the feeling of incomplete evacuation was reduced by 71.87%. There was no adverse event reported. Conclusion Nucarb is efficacious in reducing the severity of constipation, sensation of straining, bloating and abdominal pain, feeling of incomplete evacuation, and difficulty in passing gas. Since it is a herbal product, it can be safely used in all populations.
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Affiliation(s)
- Rashid Ali
- Internal Medicine, Mayo Hospital, Lahore, PAK
| | | | - Umair Akram
- Internal Medicine, Allied Hospital, Faisalabad, PAK
| | | | - Kamran Hassan
- Internal Medicine, Lady Reading Hospital Medical Teaching Institute, Peshawar, PAK
| | | | | | | | - Adeel Qamar
- Internal Medicine, Sahara Hospital, Narowal, PAK
| | - Sidra Memon
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Abdulelah M, Hajjaj N, Abu-Rumaileh MA, Clanon D, Bader H. Tenesmus: An Unusual Presentation of Delayed Prostate Adenocarcinoma Recurrence. Cureus 2021; 13:e16609. [PMID: 34336532 PMCID: PMC8312991 DOI: 10.7759/cureus.16609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 11/28/2022] Open
Abstract
We describe a case of prostate cancer recurrence 25 years after radical prostatectomy. Our patient is a 77-year-old male with past medical history pertinent for obesity and coronary artery disease. The patient’s initial presentation in 1994 was for persistent lower urinary tract symptoms. He was subsequently diagnosed with high-grade prostate adenocarcinoma and underwent radical prostatectomy. The patient was followed up postoperatively for 16 years and deemed to be in clinical and biochemical remission with undetectable prostate-specific antigen (PSA). Twenty-five years post-operatively, the patient was evaluated with an investigatory colonoscopy for tenesmus, constipation, and change in stool caliber. Colonoscopy revealed significant anal canal stenosis. Biopsy of the lesion showed prostate adenocarcinoma recurrence. Prostate cancer recurrence presenting with only gastrointestinal symptoms is highly unusual, especially in a patient who never received radiotherapy and had been in remission for 25 years.
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Affiliation(s)
| | - Nada Hajjaj
- Internal Medicine, University of Jordan School of Medicine, Amman, JOR
| | | | - David Clanon
- Internal Medicine, University of New Mexico, Albuquerque, USA
| | - Husam Bader
- Internal Medicine, Presbyterian Medical Center, Albuquerque, USA
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Ferraris EI, Giacobino D, Iussich S, Olimpo M, Valazza A, Martano M, Buracco P, Morello EM. Benign or Low-Grade Malignant Masses Occupying the Pelvic Canal Space in 11 Dogs. Animals (Basel) 2021; 11:ani11051361. [PMID: 34064742 PMCID: PMC8150968 DOI: 10.3390/ani11051361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Large canine pelvic masses, even though benign, can seriously affect dogs’ lives, causing problems regarding defecation and urination, and sometimes complete rectal and/or urethral obstruction. Many of these patients are euthanized owing to their poor clinical condition as a result of chronic compression or because their disease is erroneously considered untreatable. The aim of this study was to evaluate the clinical data of dogs with intra-pelvic benign or well-differentiated malignant masses referred to the Torino Veterinary Teaching Hospital, and treated surgically. Clinical signs, diagnostic approach, surgical procedures and outcome were evaluated. The majority of the dogs recovered uneventfully from surgery in a couple of days, with rapid resolution of the severe preoperative clinical signs. All the dogs experienced long survival with no disease recurrence or progression, even in the well-differentiated malignant tumors. Clinical findings, especially those obtained using digital rectal and vaginal exploration are mandatory for assessing the presence of the tumor and its relationship to the other pelvic structures. Currently, in the authors’ opinion, preoperative computed tomography (CT) is also highly recommended, even if this procedure was not performed in 4 out of the 11 dogs. Abstract Dogs with benign intra-pelvic rectal or vaginal masses show symptoms indicating compression on the adjacent organs. Clinical signs usually develop late when the lesion is large enough to interfere functionally. The dogs were referred for severe fecal and/or urinary tenesmus. The data collected included signalment, clinical signs, results of physical examination, pre-surgical diagnostic tests, surgical technique used, surgical complications and histological findings. Digital rectal and vaginal examination allowed the detection of a mass occupying space in the pelvic cavity in all patients. Abdominal ultrasonography and/or total body computed tomography (CT) were used to better characterize the lesion and to exclude a metastatic spread of the tumor in case of malignancy. A dorsal approach to the rectum, a dorsal episiotomy, a midline celiotomy, and a combined perineal and abdominal approach were performed to remove the mass. No postoperative complications were observed. Benign and well-differentiated malignant mesenchymal neoplasms were histologically diagnosed. As a consequence of the chronic urethral compression caused by the mass, urinary incontinence and/or urinary retention were observed for a few postoperative days. Fecal tenesmus resolved in all cases in the immediate postoperative period. The dogs’ quality of life quickly improved after surgery, especially considering the serious and life-threatening pre-surgical clinical conditions. Both the recovery time after surgery and overall survival were also evaluated.
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Affiliation(s)
- Erica Ilaria Ferraris
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Davide Giacobino
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Selina Iussich
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Matteo Olimpo
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Alberto Valazza
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Marina Martano
- Department of Medical-Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy;
| | - Paolo Buracco
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
| | - Emanuela Maria Morello
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Torino, Italy; (E.I.F.); (D.G.); (S.I.); (M.O.); (A.V.); (P.B.)
- Correspondence: ; Tel.: +39-011-670-9062
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Tagami K, Yoshizumi M, Inoue A, Matoba M. Effectiveness of Gabapentinoids for Cancer-related Rectal and Vesical Tenesmus: Report of Four Cases. Indian J Palliat Care 2020; 26:381-384. [PMID: 33311883 PMCID: PMC7725173 DOI: 10.4103/ijpc.ijpc_203_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/31/2019] [Indexed: 11/06/2022] Open
Abstract
Gabapentinoids could be assumed to relieve cancer-related rectal/vesical tenesmus based on their pharmacological mechanism. Four patients were refractory for cancer-related rectal/vesical tenesmus although their opioid doses were titrated up. Symptom intensity difference (SID) between initiation and follow-up after 24, 48, and 72 h and daily changes in the frequency of urination, defecation, opioid rescue doses, presence of sleep disruption, and dose of regular opioid medication were evaluated. The median reductions in daily discomfort measured as SID between baseline and follow-up after 24, 48, and 72 h were 87.5%, 70.0%, and 80.0%, respectively, while those in daily pain intensity were 75%, 66.7%, and 66.7%, respectively. The initiation dose of gabapentin was 200 or 400 mg/day and that of pregabalin was 75 mg/day in one patient. Gabapentinoids were effective at low doses administered over a short duration to patients with refractory cancer-related rectal/vesical tenesmus.
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Affiliation(s)
- Keita Tagami
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan.,Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Masaru Yoshizumi
- Department of Physiology and Anatomy, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Motohiro Matoba
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Palliative Medicine, Aomori Prefectural Central Hospital, Aomori, Japan
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Abstract
Background: Malignant rectal pain (MRP) and tenesmus cause significant morbidity for cancer patients at all stages of disease. There is little evidence to guide management of these symptoms. Objective: The objective of this review was to summarize the existing evidence base for palliative management of MRP and tenesmus outside of standard oncologic or surgical management. Design: A systematic review of PubMed and Embase was conducted according to PRISMA guidelines using preselected search terms for publications between 1980 and January 2017. Setting/Subjects: Studies that described management for patients with tenesmoid pain from malignant tumors of the rectum, anus, or perineum were identified. Measurements: The primary outcome was response of pain to treatment. Results: The search produced 1412 titles. Twenty articles met criteria for inclusion in the review, including 11 case series and 9 case reports. A variety of treatments were found with most patients receiving interventional procedures, but overall evidence to support any particular intervention is limited and of poor quality. Conclusions: This review highlights the limited current evidence base for medical and interventional treatments for MRP and tenesmus. Further study is needed to clarify the best approach to managing these challenging symptoms.
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Affiliation(s)
- Katelyn Mueller
- 2D Palliative Care, Burnaby Hospital, Burnaby, British Columbia, Canada
| | - Ahmer A Karimuddin
- Department of Surgery, St. Paul's Hospital, Providence Health, Vancouver, British Columbia, Canada
| | - Corey Metcalf
- Department of Medical Oncology/Palliative Care, BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
| | - Annie Woo
- Department of Pharmacy, and BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
| | - Shilo Lefresne
- Department of Radiation Oncology, BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
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Abstract
Background: The medical management of hemorrhoids should include an integrated approach. This integrated approach can be achieved by polyherbal formulations containing anti-inflammatory, styptics, analgesics, and laxative effect which reduce inflammation, pain, and bleeding, and increase gastro-intestinal motility and soften stools. One such polyherbal kit is “Arshkeyt™, a 7 day kit,” which consists of oral tablets and powder along with topical cream. Objective: Efficacy and safety of Arshkeyt™, a 7 day kit, a marketed polyherbal formulation was evaluated in comparison with conventional therapy practiced in surgery outpatient departments. Materials and Methods: Patients (n = 90) with hemorrhoids were randomly allocated to receive either Arshkeyt™ or standard therapy (combination of oral Isabgul powder and 2% lidocaine gel) for 14 days. Assessment on the basis of rectal symptoms and proctoscopic examination was done on day 0, 7, and 14 to derive a “composite score” which ranged from 0 to 25 by a blinded evaluator. The primary endpoint was number of patients achieving composite score 0 at the end of therapy (day 14). Inter-group analysis was done using Chi-square test. Results: On day 14, the composite score of 0 was achieved in 15 patients of Arshkeyt™ group versus 6 patients receiving standard therapy. The symptoms and signs which showed significant improvement in Arshkeyt™ group compared to standard treatment group were the tenesmus (visual analog score) score (P = 0.047), anal sphincter spasm (P = 0.0495) and a decrease in the grade of hemorrhoids (P = 0.0205) on day 14. Arshkeyt™ was also more beneficial in case of bleeding hemorrhoids as compared to nonbleeding hemorrhoids (P < 0.05). The incidence of adverse drug reactions in both groups was comparable and no patient required any treatment for the same. Conclusion: “Arshkeyt™, a 7 day kit,” was effective in the treatment of hemorrhoids and had a good safety profile.
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Affiliation(s)
- Raakhi K Tripathi
- Department of Clinical Pharmacology and Therapeutics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Somesh S Bolegave
- Department of Clinical Pharmacology and Therapeutics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Parvan A Shetty
- Department of Clinical Pharmacology and Therapeutics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Dinesh A Uchil
- Department of Clinical Pharmacology and Therapeutics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Nirmala N Rege
- Department of Clinical Pharmacology and Therapeutics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Mukesh B Chawda
- Senior Manager, Medical Services, Solumiks Herbaceuticals Limited, Mumbai, Maharashtra, India
| | - Sameer A Rege
- Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Abstract
Splenosis is a rare condition defined as seeding and autotransplantation of splenic tissue, typically after blunt abdominal trauma (e.g. from road traffic collision). Sites of splenosis ranging from intrathoracic to intrapelvic have been reported, and symptoms vary greatly depending on the site and size of lesions. We present the use of Tc-99m sulphur colloid SPECT/CT in diagnosing a case of multiple abdominopelvic splenosis as the cause of new-onset tenesmus and constipation, which was initially thought to be due to colorectal malignancy, 47 years following the initial abdominal trauma.
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Affiliation(s)
- King Kenneth Cheung
- Department of Nuclear Medicine, Royal Free Hospital, London, UK ,Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU UK
| | - Thomas Wagner
- Department of Nuclear Medicine, Royal Free Hospital, London, UK
| | - Margaret Hall
- Department of Nuclear Medicine, Royal Free Hospital, London, UK
| | - Lee Dvorkin
- Department of Surgery, North Middlesex Hospital, London, UK
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Bruderer A, De Brot S, Nuss K. [ Tenesmus and stranguria in a heifer caused by a urachal cyst in the bladder wall]. Tierarztl Prax Ausg G Grosstiere Nutztiere 2013; 41:326-329. [PMID: 24127001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 01/21/2013] [Indexed: 06/02/2023]
Abstract
A 10-month-old Brown Swiss heifer was referred to our clinic be- cause of pollakiuria, stranguria and tenesmus. Ultrasonography and endoscopy revealed a cyst-like lesion at the apex of the urinary bladder. The apex of the bladder was surgically removed with the patient in dorsal recumbency under general anaesthesia. Histological examination revealed a cyst lined with urothelium in the wall of the urinary bladder. The heifer was discharged 9 days after surgery. According to the owner's information the animal did not show any clinical signs 6 months later.
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Affiliation(s)
- A Bruderer
- Karl Nuss, Prof. Dr. med. vet., Dipl. ECVS, Dipl. ECBHM, Departement für Nutztiere, Vetsuisse-Fakultät der Universität Zürich, Winterthurerstrasse 260, 8057 Zürich, Schweiz, E-Mail:
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