ABSTRACT
Prostate cancer [PCa] is one of the leading cancers in older males. The aim of this study was to evaluate the clinicopathological characteristics of prostate cancer and rate of detection of prostate cancer by DRE [digital rectal exam] in patients presenting to a tertiary care private sector hospital in Islamabad, and determine the awareness about PCa in these patients. There were 226 patients who presented from December 2009 to December 2015 having mean age of 68.63 +/-8.76 years and median Prostate Specific Antigen [PSA] value of 19.12 ng/mL [IQR=35.8]. Median prostatic volume was 49 [IQR=22] gram/cc in the subjects. DRE was abnormal in 164 [72.56%] patients and normal in 62 [27.43%] patients only. Majority of patients presented relatively late, which may be due to lack of screening programme or public awareness
ABSTRACT
Partial nephrectomy is the preferred procedure in benign renal lesions requiring surgical removal. It has also been accepted procedure for malignant renal conditions of smaller size. The aim of this observational study was to determine the outcome of partial nephrectomy in terms of complications and recurrence rates. Twenty patients with renal mass underwent this procedure from January 2010 till June 2014 at our Department, with mean age of 46.51 +/- 1.53 years. There were 14 males and 6 females. Renal mass on CT scan had the mean size of 3.80 +/- 1.15cm. The mean hospital stay in this series was 5.11 +/- 1.42 days, while mean operative time was 247 +/- 79.71 minutes. Twelve patients had malignant histology. They were followed using CT scan abdomen and pelvis with contrast at six and 12 months. Out of these, 10 [83.3%] patients were found to have no recurrence after six months
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Kidney Neoplasms/surgery , Neoplasm Recurrence, LocalABSTRACT
Objective: To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017
Methodology: The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure. Patients were analyzed for operative time, age, hospital stay, and peroperative and postoperative complications. Chart review was done for collection of data on specified proforma
Results: There were 73 patients with mean age of 1.81 +/- 0.92 years. Children were discharged on the same day. None of them needed catheterization and dressing. Temporary dressing was used for mild bleeding immediate post op in 13 [17.80%] cases only. Postoperative complication such as urinary retention, fever, severe pain, or urinary tract infection were not seen in children. Meatal stenosis was not seen on a 2-24 months' follow-up. Satisfactory urine stream and good cosmesis was noted by the parents
Conclusion: The Firlit technique for the repair of glanular hypospadias was simple and satisfactory in terms of urine stream and cosmesis with minimal complications
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Objective: To compare the outcome of percutaneous nephrolithotomy [PCNL] in terms of operative time, hospital stay, stone clearance, and postoperative complications in adult versus paediatric patients
Study Design: Descriptive case series
Place and Duration of Study: Shifa International Hospital, Islamabad, from January 2010 to December 2013
Methodology: A retrospective analysis of 155 patients who underwent PCNL from January 2010 to December 2013. The patients were divided into 2 groups: patients aged ? 12 years were included in paedriatic group [A] while patients aged > 12 years were included in adult group [B]. The patients were analyzed for age, gender, stone size, operative time, stone clearance, hospital stay, and peroperative and postoperative complications. Data was collected by chart review on specified proforma
Results: One hundred and twenty-nine [129] patients including 44 [34.10%] females and 85 [65.89%] males with a mean age of 45.00 +/- 1.44 years were adults. Twenty-six palrents with mean age of 9.21 +/- 5.70 years, 17 [65.4%] males and 9 [34.6%] females, were included in the paedriatic group. Mean stone size was 2.12 +/- 1.01 cm in paedriatic group compared to 2.52 +/- 0.77 cm in adult group [p = 0.023]. Mean operative time in paedriatic group was 158.8 +/- 39.63 minutes compared to 119.34 +/- 37.06 minutes in adult group [p < 0.001]. Mean hospital stay in paedriatic group was 2.76 +/- 1.14 days compared to 3.12 +/- 1.27 days in adult group [p=0.1881]. Peroperative stone clearance was in paedriatic group was 93.28 +/- 9.23% compared to 90.81 +/- 12.23% in adult groups [p = 0.331]. One patient in the adult group developed urosepsis
Conclusion: There was no significant difference in outcome of percutaneous nephrolithotomy in terms of hospital stay, stone clearance, and postoperative complications in adult versus paediatric patients. Operative time was significantly shorter in adult cases compared to paedriatic cases
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Objective: To determine a difference in the stone-free-rate among different renal locations in children after extracorporeal shockwave lithotripsy [ESWL]
Study Design: A descriptive study
Place and Duration of Study: Urology Department, Shifa International Hospital, Islamabad, Pakistan, from January 2007 to June 2015
Methodology: The study included children who underwent ESWL, divided into three groups based on location of stones in kidney as group A [lower pole stones], group B [upper and mid pole stones] and group C [renal pelvis stone], respectively. ESWL was done by standard technique using Storz Modulith SLX lithotripter 3rd generation. Data was collected by chart review. SPSS version 16 was used for data analysis
Results: Among 76 children with mean age of 7.55 +/- 4.16 years, 55 [72.4%] were males whereas 21 [27.6%] were females. Mean stone size was 1.08 +/- 0.59 cm. There were 34, 17 and 25 cases in groups A, B and C, respectively. Post-ESWL stone-free-rate was 47% in lower pole stones, 70.58% in upper and mid pole stones, and 68% in renal pelvis stones. Hematuria was seen in one patient from each group, sepsis in two patients from each of the mid pole/upper pole and lower pole group, while Steinstrasse in one patient from each group
Conclusion: ESWL is a safe and effective way of treating renal stones in all poles in pediatric population
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Objective: To determine the outcomes of pediatric patients who underwent ureteroscopic removal of ureteric stones in terms of stone free rates and complications
Study Design: Descriptive case series
Place and Duration of Study: Urology Department at Shifa International Hospital, Islamabad, from January 2012 to December 2014
Methodology: A retrospective analysis of 37 patients, who underwent ureteroscopy for the treatment of ureteral calculi at the study centre, was conducted. Data regarding mean stone size, stone location, stone clearance and complications was recorded on specified proforma. Data was analysed on SPSS version 16
Results: Thirty-seven children with mean age of 8.36 +/- 5.17 years were included. Twenty-five [67.6%] patients were male, whereas 12 [32.4%] patients were female. Mean stone size was 10.01 +/- 6.24 mm. Location-wise 25 [67.56%] patients had upper ureteric stones, 5 [13.5%] patients had mid ureteric stones and 7[18.9%] patients had distal ureteric stones. Twenty two [59.5%] children underwent one procedure, while 15 [40.5%] children underwent relook ureteroscopies. Second relook ureteroscopy was done in 13/25 [52%] patients, 1/5 [20%] patient and 1/7 [14.28%] patient in upper, mid and lower ureteric stones, respectively. Overall stone clearance rate was 35/37 [94.59%] after first procedure. Mean operative time was 52.54 +/- 12.39 minutes. Urosepsis was seen in 2 patients. No major complications were seen. After the second URS procedure, stone free rate was 100%
Conclusion: Ureteroscopy is a safe and effective procedure in children in terms of stone free rate and complications
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Objective: To determine the demographic features and causes of donor deferral in blood donors
Study Design: Descriptive study
Place and Duration of Study: Conducted at the Armed Forces Institute of Transfusion [AFIT] for a period of 1 year from Jun 2012 to May 2013
Material and Methods: Donors with ages ranging from 18-60 years who reported to the blood bank were incorporated in this study. A comprehensive history was taken from all the potential donors through a structured proforma. A detailed general physical examination was done by the appointed doctor at the blood bank. Furthermore, laboratory testing of the blood samples of potential donors was done. On this basis, donors were accepted or deferred
Results: The commonest cause of the donor deferral was hepatitis C [HCV] [28.6%], the second leading cause was anaemia [24%] and the third leading cause was hepatitis B [HBV] [16.8%]. Syphilis was also a major cause of donor deferral causing the rejection of 10.4% donors
Conclusion: The donor deferral rate is 7.3% and the leading course of donor deferral are chronic infections like hepatitis C and B and diseases like anaemia
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To find out the effect in increase in serum 25 [OH] vitamin D levels after supplementation with 1000 lU/day of vitamin D in patients with low vitamin D levels and other factors which may affect the increase in vitamin D levels. Retrospective study. January 2013 and June 2014. Ch. Rehmat Ali Trust Teaching Hospital in the Lahore. The study included patients > 50 years with a low-energy fracture and a vitamin D level < 25 nmol/l. 85 patients were included, mean basal 25 [OH] vitamin D level was 22 nmol/l. After a mean of 10 weeks, the mean increase in vitamin D was 49.5 nmol/l. Only 45.1% reached the target level of > 50 nmol/l. The increase was correlated with the basal level of vitamin D [p < 0.05], and the time interval between the two vitamin D measurements [p < 0.05] and was inversely related to body weight [p < 0.05], but was not related to age, gender or renal function. We found that the generally recommended dosage of 1000 IU of vitamin D per day resulted in suboptimal serum levels after ten weeks of treatment in more than half of the patients. The increase in vitamin D levels was higher in patients with low body weight and in patients with very low basal vitamin D levels. These data suggest that these patients should initially be treated with higher dosages of vitamin D. If not possible, vitamin D measurements should be performed after at least six months of supplementation with dosage adjustment
Subject(s)
Humans , Male , Middle Aged , Female , Aged , Vitamin D Deficiency , Retrospective Studies , 25-Hydroxyvitamin D 2 , Fractures, BoneABSTRACT
To describe Paediatric Percutaneous Nephrolithotomy [PCNL] in terms of safety and efficacy in a group of 26 children. An observational study. Shifa International Hospital, Islamabad, from January 2011 to June 2013. PCNL of 26 children was done by standard technique. The patients were analyzed for age, gender, presenting symptoms, stone size, site, PCNL approach, operative time, stone clearance, hospital stay and per-operative and postoperative complications. Descriptive statistics were obtained. The mean age was 9.21 +/- 5.70 years. Seventeen [65.4%] patients were male whereas 9 [34.6%] patients were female. Flank pain was the most common presenting symptom. Mean stone size was 2.21 +/- 1.04 cm. Mean operative time was 158.8 +/- 39.63 minutes and mean hospital stay was 2.84 +/- 1.14 days. Postoperative transfusion was required in only one case [4%]. There was no episode of sepsis or perinephric collection. Per-operative stone clearance was 93.28% +/- 9.23%. Conversion to open was seen in one [4%] case. DJ stent was placed in 7 [27%] cases. PCNL is a safe and effective way of treating renal stones in paediatric age group
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To assess the students' perception of educational environment of Army Medical College, Rawalpindi, Pakistan and to determine gender difference in this perception. A survey-based study. Army Medical College, Rawalpindi, Pakistan from Jan 2012-June 2012. Dundee Ready Education Environment Measure [DREEM] questionnaire was administered to 805 1[st] year to 5[th] year MBBS students of AM College, after written and informed consent. DREEM total and subscores were calculated according to Likert scale. Comparison was made for responses of male and female students as well as among students of each class by student's t test and ANOVA. Valid responses were 647 out of 805 [response rate = 80.17%]. The education climate was rated as more positive than negative determined by overall DREEM scores [mean 116.57 +/- 24.96]. Students perceptions of learning, teachers, academic self-perception, atmosphere and social self-perception were determined by sub scales and responses were found to be more on the positive side though sub scores of academic perception were highest [19.32 +/- 5.25] and those of social self-perception were lowest [15.42 +/- 3.85]. There was no statistical difference in perception of male and female students [p = 0.12]. The sub scores were significantly higher in 1[st] year students but all other classes had almost similar scores [p = 0.06] on ANOVA and post hoc tukey's test. Army Medical College as an institution has a positive education environment where most of the students feel positive about education climate, learning environment, teachers, their own academic achievements, institutional atmosphere and their social well-being
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To determine the frequency and severity of leucopenia during antiviral treatment in patients with hepatitis C and the effectiveness of G-CSF [Granulocyte-Colony Stimulating Factor] in its management. An observational study. Shafi Clinic, Rawalpindi, from July 2005 to July 2007. Patients with Polymerase Chain Reaction [PCR] positive for Hepatitis C Virus-Ribonucleic Acid [HCV-RNA] by Enzyme Linked Immunosorbent Assay [ELISA] method were included in the study. Standard combination therapy was given to all i.e. interferon and ribavirin. Those with total leukocyte count [TLC] <4000/cmm were given injection Granulocyte-Colony Stimulating Factor [G-CSF] according to severity of leucopenia. Response to therapy was noted and dose titration was done accordingly. A total of 208 patients were enrolled in the study with 99 [48%] males and 109 [52%] females. Total leukocyte count [TLC] < 4000/cmm was observed in 78 [37.5%] cases. Conventional interferon induced leucopenia was seen in 60 out of 172 [35%] cases. Pegylated interferon induced leucopenia was seen in 18 out of 36 [50%] cases. Patients on Pegylated interferon had more severe leucopenia as compared to those on conventional interferon. Granulocyte-Colony Stimulating Factor [G-CSF] administration resulted in an increase in mean total leukocyte count from 2300 to 5200/cmm. No patient required antiviral dose reduction or discontinuation. Recombinant Granulocyte-Colony Stimulating Factor [G-CSF] administration tends to manage leucopenia, which is a common adverse effect of antiviral treatment for hepatitis C