ABSTRACT
Objective: To discover the burden of focal segmental glomerulosclerosis in patients of nephrotic range proteinuria [i.e.>3.5gm/24 hours/ 1.73m[2] body surface area]
Study design: A case series study
Place and duration: At the department of Nephrology Jinnah Post Graduate Medical Centre from 1st May 2011 to 30th Nov 2011
Methodology: Patients with nephrotic range proteinuria diagnosed by 24 hours urinary protein [>3.5gm/24 hours/1.73m[2] BSA] were included. Serum creatinine, total proteins, serum albumin, 24 hour urinary proteins, creatinine clearance, coagulation profile as well as renal biopsy was performed in every patient. In renal biopsy <50% glomerular involvement with involvement of a portion of the glomerular tuft was confirmed as patients having the focal segmental glomerulosclerosis
Results: The mean age of the patients was 25.93 +/- 5.923 years. Out of 144 patients there were 38[26.38%] females and 106[73.31%] males. There were 67[46.5%] patients with focal segmental glomerlusclerosis with nephrotic range proteinuria
Conclusion: The burden of focal segmental glomerulosclerosis in patients with nephrotic range proteinuria is high
ABSTRACT
To determine the efficacy of Alpha blocker as adjunctive medical therapy, which increases the stone clearance after extracorporeal shock wave lithotripsy [ESWL] to treat renal stones. Quasi Experimental study. Department of Urology, Liaquat National Hospital, Karachi. September 2010 to March 2011. Ultrasound guided Dornier Alpha Impact lithotripter was used for shock wave lithotripsy. Study was carried out on 60 patients who underwent single session of ESWL for renal calculus. Patients were divided in two groups, Group A [n=30] received conventional treatment and Group B [n=30] received Alpha-1 Blocker in addition to conventional treatment. All patients were evaluated with X-ray and Ultrasound [KUB] after 2 weeks and repeated at the end of month. Failure is defined as unsuccessful expulsion after 4 weeks and patient desire to remove the stone before day 30. Out of 60 patients, 45[75%] were males and 15[257%] were females with male to female ratio was 3:1. The average age of the patients was found 36.32 +/- 14.8 [Ranging from 15 to 75] years. Complete clearance was achieved in 76.7% of those receiving Alpha-1 Blocker and in 46.7% of controls at 1 month [P = 0.001]. This difference was statistically significant. The results of my study demonstrate that Alpha-1 Blocker therapy, as an adjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equally safe
ABSTRACT
Objectives: to determine the frequency of simple nephrectomy in patients presenting with Urolithiasis
Material and methods: this is a retrospective study of patients presented at University hospital with urolithiasis during January 2007 to December 2010. The data were collected for patients who underwent nephrectomy for stone disease
Results: total number of patients admitted with urolithiasis was 2600. Out of these, 88 [3.38%] patients underwent simple nephrectomy for non-functioning kidney. Mean age of patients was 32.5 years, males were 62 [70.45%] and females were 26 [29.55%]. Flank pain was predominated symptom in 88% of patients. Mean duration of symptoms was 2.4 years. Mean size of stone was 4.1cm. Seventy patients had stones in renal pelvis
Conclusion: percentage of calculus nephrectomy among patients of urolithiasis is 3.38%
ABSTRACT
Objective: to determine the pattern and sensitivity of pathogens causing urinary tract infection at tertiary care hospital
Methods: using clean catch method, urinary samples were collected from patients admitted in Urology Ward, Liaquat University Hospital Jamshoro from 1[st] January 2011 to 31[st] December 2011 who had suspected urinary tract infection. Samples sent to Diagnostic and Research Laboratory at Pathology Department, Liaquat University of Medical and Health Sciences, Jamshoro. All samples were tested by international standard method under supervision of qualified microbiologist. Antibiotic sensitivity of isolated micro-organisms was tested for commonly used antibiotics by Kirby Baur technique
Results: out of admitted patient's total of 458 samples were sent during study period. Significant bacteriuria was found in 335 [73.14%] samples, insignificant bacteriuria in 23 [5.02%] samples, while 100 [21.8%] samples were sterile. The most common pathogens isolated were E Coli in 297 [64.41%] samples, Klebseilla Spp and Enterobacter each in 51 [11.31%] samples, Proteus in 36 [7.8%] samples, Pseudomonas in 15 [3.27%] samples and Citrobacter in 8 [1.74%] samples
Conclusion: seventy three percent of samples showed significant growth. High yield of positive cultures showed good clinical co-relation in suspected cases of UTI. Organisms isolated in urine cultures were gram negative rods. Study proves that pathogens causing urinary tract infections are developing resistance against commonly used antibiotics
ABSTRACT
Objective: to document the feasibility and clearance rate of Percutaneous Nephrolithotomy for proximal ureteric stones
Patients and methods: this was a retrospective review of patients who presented with upper ureteric calculi of 1.5 cm or more at Department of Urology Liaquat University of Medical and Health Sciences Jamshoro which is one of the busiest Urology centre in Sindh. Patient's demographic data, clinical presentation, radiological findings, operative finding and clearance were noted on a proforma. All patients who had preoperatively urinary tract infections were treated with appropriate antibiotics. Those who presented with urosepsis, raised creatinine and hydronephrotic kidneys underwent percutaneous nephrostomy tube to drain the infected urine and optimize for definite treatment. Before puncturing the kidney, stones were pushed back in the kidney with the help of ureteric catheter and ureteroscope. Open ended 5 Fr ureteric catheters placed for opacification of pelvicalyceal system followed by percutaneous nephrolithtomy procedure. Data was analyzed on SPSS version 16
Results: from January 2006 to December 2010, Percutaneous Nephrolithotomies were performed for 101 patients with upper ureteric stone. There were 70 males and 31 females with mean age of 26 years. The location of stone[s] confirmed and function of the kidneys was assessed with an Intravenous Urogram or CT Kidney Ureter and Bladder. Majority of patients had gross hydronephrosis with a stone diameter ranging from 1.5cm to 2.6cm with mean of 1.9 cm in size. Percutaneous Nephrolithtomy was the modality of treatment. At the end of the procedure 18 Fr nephrostomy or 6fr Double J Stent was left for all the patients, which was removed after 2 and 14 days respectively. Post -operative x-ray KUB or Ultrasound KUB was done to confirm the clearance. Complete clearance was noted in 99 [98.7%] patients. Regarding complications, 2 patients had post-PCNL Urosepsis and 4 patients required blood transfusions secondary to hemorrhage
Conclusion: percutaneous Nephrolithotomy is safe, economical and effective method in treating impacted upper ureteric stone
ABSTRACT
To assess the complications of suprapubic cystolitholapaxy as an alternative procedure for bladder stones in pediatric age group. Prospective analystical study. This study was carried out in Department of Urology, University of Medical and health sciences Jamshoro from May 2006 to December 2010. this study consisted of 148 patients admitted though the outpatient department of Liaquat University Hospital Jamshoro/Hyderabad. All patients underwent base line and specific investigations especially ultrasound of abdomen and pelvis as diagnostic modality for assessment of bladder stones. Inclusion criteria were all these patients who after counseling for this study and gave written consent parents. Irrespective of their sex and age < 12 years of age presented with bladder stone of < 3cm. Exclusion criteria included were patients having history of previous surgery, posterior urethral valves, stricture urethra and stone > 3 cm were excluded from the study. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 148 patients, 124 [83.78%] were boys and 24 [16.21%] were girls with ratio 5.1:1 respectively. Mean age of the patients was 5.3 years with range from 1 to 11 years. Twelve [8.1%] patients presented with retention of urine due to impacted stone at bladder neck or prostatic urethra while 16 [10.81%] patients had coexisting renal stones. The mean size of the stones was 1.9 cm with range from 1.1 to 2.8 cm. Total operative time ranged from 25 to 40 minutes. Patients were discharged after observing first void on 2[nd] post-operative day 136 [91.89%] while twelve [8.11%] patients required further stay due to either suprapubic urinary leakage in 5[3.37%] or urinary retention in 7[4.72%] patients. Percutaneous suprapubic cystolitholapaxy is safe and cost-effective alternative to open surgery in children with
Subject(s)
Humans , Female , Male , Urinary Bladder Calculi/surgery , Urethral Diseases/therapy , Urinary Retention , PediatricsABSTRACT
To compare the outcome of three way foleys catheter removed on 2[nd] and 5[th] day after Transurethral resection of Prostate for BPH regarding postoperative retention of urine, urine culture and hospital stay. Quasi Experimental study. This study was carried out in Department of Urology, University of Medical and health sciences Jamshoro from July 2010 to December 2011. This study consisted of 50 patients were divided in two groups. Group A for catheter was removed on 2nd post operative day of Trans Uretheral resection of prostate and group B for catheter was removed on 5th Post Operative Day of Trans Uretheral resection of prostate, each group consist of 25 patients. Detailed History was taken from all the patients with special regard to the urinary retention. Inclusion criteria were that all diagnosed as case of BPH on the basis of history and investigations. Exclusion criteria included unfit patients for general anesthesia, presented with chronic urinary retention, hematological disorders, pre operative infected urine and concurrent uretheral structure. Re-catheterization were in 2 patients [8%] group A and 1 patient [4%] in group B. Post operative urine culture growth of organism [bacteriuria] were 1 patient [4%] A and 3 patients [12%] in group B. Duration of hospital stay in group A was 5.68 as compared to the patients in group B was 8.44 days. In conclusion, early catheter removal had a dramatic impact on hospital stay. Catheters can be removed early after transurethral resection of prostate with no increase in morbidity and maintain the efficacy of the procedure, resulting in considerable savings to their patients. Our study confirms the safety of an irrigation-free and early catheter removal policy after TURP