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Urachal tumours are rare vesical neoplasms. We report a case of urachal adenocarcinoma in a 31-year-old patient.

Objectives: The purpose of this study was to investigate the effect of trunk stabilization exercise using a gym ball with or without electromyography biofeedback for people with chronic low back pain. Design: Pretest-posttest Experimental - control group design. Method: 30 subjects were randomly assigned into two groups. Experimental group received trunk stabilization exercise along with the electromyography biofeedback whereas control group received trunk stabilization exercise without electromyography biofeedback. Endurance and Pain was measured at 0 week, 2nd week, 4th week and 6th week. Results: Trunk stabilization exercise along with Electromyography biofeedback significantly improves the endurance and reduces pain. / Conclusion: from the result we may conclude that trunk stabilization exercise along with the electromyography biofeedback is more effective than trunk stabilization exercise without electromyography biofeedback in rehabilitation of patient with chronic low back pain.

Objective: To establish the best possible long term effective choice of treatment program for deactivating MTrP's by using the combination of muscle energy technique with strain-counterstrain technique Design: Pretest-Posttest control group design Setting: Outpatient physiotherapy department, Taneja Hospital, Preet Vihar New Delhi. Patients: Fourty five subjects (only male) with Myofascial Trigger Points Pain. Subjects were randomly placed into three groups: Experimental group A (n=15), Experimental group B (n=15) and a Control group C (n=15). Intervention: The experimental group A received muscle energy technique in combination with straincounterstrain technique and experimental group B received muscle energy technique alone whereas control group received conventional treatment only. Main Outcome Measures: Pain pressure threshold was assessed with the pressure threshold meter (PTM). Pain and functional status of the patients were measured by a visual analogue scale (VAS) and the Neck Disability Index scores respectively. Results: Within group analysis revealed significant improvement in pain pressure threshold, functional status and reduction in pain intensity in all groups. Between group analysis revealed significant difference between group A, group B and group C. Further post hoc analysis revealed significant difference between group A and B, group A and C and group B and C for all variables even after one week of follow up after the termination of intervention. Conclusion: The combination of muscle energy technique with strain-counterstrain has been shown to produce greater improvement in pain pressure threshold on pressure threshold meter, function status on neck disability index scores and reduction in pain intensity on visual analogue scores even after one week of the termination of intervention. This shows the long term effectiveness of combination of two manual techniques deactivating the myofascial trigger point's pain.

In adults but not children, small-bowel intussusception is usually traceable to a physical lesion. We report a causation that does not seem to have been described before.

Sir, We read with great interest the retrospective study by Wong et al . [1] about the validity of applying NICE guidance in the management of men with low-risk prostate cancer. Namely, whether active surveillance (AS) was an appropriate primary recommendation in men diagnosed with low-risk disease in an unscreened population. The authors caution against AS after fi nding that about one-third of men with ‘low-risk’ disease on TRUS-guided biopsy were found to have more advanced disease in the prostatectomy specimen.

Smith and colleagues’ findings on quality of life after diagnosis and treatment of localised prostate cancer1 are neither new nor unexpected.2 3 While much resource has gone into refining both radiotherapeutic and surgical approaches to care, the key question is: has increased specification decreased the toxicity of prostate cancer …

Reply to TS Clark: ‘High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series’

Reply to S Eggener, M Gonzalgo and O Yossepowitch: ‘High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series’

The author should be congratulated for writing this overview of laboratory skills that, to my knowledge, has not been covered in any other publication. It is something that has been sorely needed by the countless postgraduates and clinical research fellows who have wished to venture into the painstaking discovery of new knowledge. Written for any student at any level who is about to embark on such a project within a scientific laboratory, it should provide a new surgical research fellow with a welcome practical bridge from clinical work to basic science. Written in an informal and friendly manner, the book is divided into two sections. Section one covers basic concepts such as laboratory safety, chemical concepts, design and management of experiments, record keeping and scientific writing. Section two covers actual biomedical techniques such as Western blotting, ELISA, histological techniques, immunostaining, cell culture, Northern and Southern blotting, polymerase chain reaction (PCR), microarray and finally the use of animals. Every chapter gives a practical overview, which will help overcome the initial sense of abandonment one may feel when starting a research project and that other books in molecular biology distinctly miss. However, I disagree with the author's assertion that it can be used as a day-to-day guide that the student can continuously come back to as the detail is just not there. For example, in the description of making a primer for PCR. Nevertheless, a good laboratory supervisor can help to build on what the book provides. In addition, guidance on writing grant applications within the scientific writing chapter would be useful. The reader is, however, provided with useful references (mainly websites), which will aid in filling out the details in a way in which traditional publications cannot. Overall, I would recommend this book for those starting in a new laboratory. It does what it says in the title and provides an introduction and a bridge into what can be an overwhelming start to a new research career.

Commenting on the systematic review by Lourenco et al,1 we wish to make several specific and general points. The contention that holmium laser enucleation holds most promise in challenging transurethral prostatic ablation (TURP) belies the fact that this technique has a steep learning curve and requires careful morcellation of the prostate in the bladder once enucleated. …