ABSTRACT
To share our experience regarding the safety and efficacy of Percutaneous Nephrolithotomy for the treatment of renal stones of larger than 2.5 cm and to study the frequency of any postoperative complications associated with this procedure. This is a descriptive study conducted during the period from June 2007 to December 2009. Using non-probability convenient sampling, total 88 patients with renal stones of more than 2.5 cm were selected for PCNL. Data was analyzed on SPSS version 10 for windows XP. In a cohort of 88 patients [57 male and, 31 female] PCNL was performed for renal stone treatment. The mean age was 33.5 [9 - 65] years. The mean operative time was 85 [60 - 180] minutes and the mean stone size was 3.2 cm range [2.5-4.8] cm. There were 37 staghorn and 51 non staghorn stone. PCNL via a single access tract was accomplished in 86% [76/88] of procedures, with upper pole calyx in 30, middle calyx in 27 and lower pole calyx in 19 procedures, while multiple tracts were used in 14% of procedures [12/88] with 09 procedures using the upper and middle calyxes and 05 procedures using lower and middle calyxes. The stone-free rates for staghorn stone at discharge and at 3 months were 83.7% and 90.8% respectively, while for non staghorn stone the figures were 85.8% and 92.5% respectively. Postoperative complications were observed in 9% of the procedures [8/88], the commonest of which was bleeding necessitating blood transfusion in 4 patients. PCNL is safe and Effective treatment for renal calculi associated with less morbidity, shorter hospital stay and is cost effective
ABSTRACT
Peptic ulcers were believed to be caused by stress, dietary factors, and gastric acid, but the link between H. pylori and peptic ulcers was identified in 1983. To see the frequency of Helicobacter pylori infection in patients with perforated duodenal ulcer and advise eradication therapy in these patients. This cross sectional study was conducted in Surgical Unit Hayatabad Medical Complex, Peshawar, during January 2007-June 2008. A total of 50 cases were included in the study. All cases presenting to our unit with acute perforated duodenal ulcer were recruited. After resuscitation and baseline investigations, all underwent emergency laparotomy via upper midline incision, after thorough peritoneal lavage, the perforation margins were freshened and closed over an omental patch. Serum from every patient was tested for H. pylori and accordingly managed. Out of the 50 cases, 45 were males, and 5 were females. Age ranged from 20- 80 years old. All patients underwent emergency laparotomy. Postoperatively, all were started on PPI treatment and serum testing for H. pylori was done. Thirty-four [68%] turned out positive and 16 [32%] were found to be negative for H. pylori. There is still a high frequency of H. pylori infection in patients with perforated duodenal ulcer. But comparing these results with the various data available, there is a significant decline in H pylori positive perforated duodenal ulcer patients