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APMC-Annals of Punjab Medical College. 2016; 10 (2): 85-91
in English | IMEMR | ID: emr-185523


Introduction: Renal stones have been one of the most commonly encountered diagnosis in patients visiting Urology clinics and Extra-Corporeal Shock Wave Lithotripsy [ESWL] has been an effective method for management of renal stones of certain size [Up to 2.5 cm]

Objective: To determine the complication rates in patients undergoing ESWL to look for safety level of the procedure. Duration And Setting: Study was conducted From December 2015-March 2016 in Kidney Center, DHQ Hospital, Faisalabad

Methodology: First 225 patients undergoing ESWL at Kidney Center, DHQ Hospital, Faisalabad were included in the study and they were observed for short term complications as post procedure pain, hematuria, fever and ureteric obstruction

Results: 225 patients included in the study. Among them 132 [58.7%] were male, 93 [41.3%] were female. Average age of patient was 38.2 years with minimum range as 5 years and maximum as 75 years. Stone size ranged from 7mm to 2.5cm with average size as 1.541cm. Fragmentation was observed in 218 [96.9 %] patients in first two sessions while no fragmentation was observed in 7 [3.1%] patients after two sessions. Out of 225, 37[16.4%] patients developed pain, 19 [8.4%] observed hematuria, 7 [3.11%] have fever and 6 [2.66%] developed ureteric obstruction. Only 3 patients developed two complications simultaneously. No statistical association was found for development of complication after ESWL in our study

Conclusion: Inference drawn from the statistics clearly showed that ESWL is still a very safe and effective modality for renal stone management

APMC-Annals of Punjab Medical College. 2016; 10 (1): 36-40
in English | IMEMR | ID: emr-185534


Objectives: To determine the significance of indwelling time for bacterial colonization of DJ stents by measuring the frequency of bacterial colonization in such stents after endoscopic Urological surgery. Place And Duration: Study was done from September 2014 to November 2015 [15 months] in Department of Urology and Kidney Transplantation, Allied Hospital, Faisalabad

Methodology: 68 patient were included in the study who undergone Percutaneous nephrolithotomy [PCNL] and Ureterorenoscopy [URS] for renal and ureteric stones respectively with DJ stenting. Sterile nature of urine was assured in pre-operative circumstances and patients with active urinary tract infection were excluded from the study. Urinary cultures were performed at 2-4 weeks, 5[th] week and more than 6[th] week of indwelling time and lower end of DJ stent cultures were also performed after removal

Results: 68 patients were included in the study with mean age 48.5 years [20-77 years age limits]. Among 68, 38 were male patients and 30 were female. Percutaneous nephrolithotomy [n = 5] and ureterorenoscopy [n =63] were the procedures after which DJ stenting was performed. Out of 68, 36 patients undergone right sided stenting and 32 patients undergone left side ureteric stenting. Urine culture was positive in 1 [1.47%] case and DJ stent cultures were positive for bacterial colonization in 4 [5.8%] cases. We do not found any statistical association between stent culture analysis and variables like gender, age of patient, or laterality. However we find statistical significance between stent indwelling time and colonization as evident by the results that the rate of colonization was 2.7% when indwelling time was less than 4 weeks, 4% colonization when indwelling time was 5 weeks as compared to 28.5% colonization when indwelling time was more than 6 weeks

Conclusion: These results showed that colonization rates increases when indwelling time increases especially when indwelling time exceeds 6 weeks. This study also refers to the fact that DJ stents can be kept safely for maximum duration of 6 weeks and indwelling time greater than 6 weeks will be associated with complication of urinary tract infection. Moreover this study also showed that one may find an infected colonized stents even if urine culture is negative for any growth

APMC-Annals of Punjab Medical College. 2016; 10 (3): 166-169
in English | IMEMR | ID: emr-185644


Background: Penile carcinoma is an uncommon condition, accounting for less than 1% of all male cancers. It typically presents as a superficial lesion involving the Glans and Penile Shaft. Risk factors for penile carcinoma include phimosis, human papilloma virus infection and tobacco smoking. The spread of the tumor to the loco-regional lymph nodes is the most relevant prognostic factor

Case Presentation: The current case report is about a 65 years old male who presented with non-healing ulcer involving glans and shaft of penis for two months. Examination of Perineum revealed an ulcer of size about 3 cm in length involving glans and distal penile shaft, with eaten up most of glans surface. Wedge biopsy histopathology report showed moderately differentiated Squamous cell carcinoma of the penis involving sub-epithelial tissue with lympho-vascular invasion and involvement of corpora cavernosa. CT-Scan abdomen with IV contrast showed no evidence of metastasis or lymphadenopathy. So partial penectomy was planned and carried out subsequently

Conclusion: Although squamous cell carcinoma of the penis a rare disease, mainly affecting the elderly population but all the penile ulcers not responding to medial therapy must be evaluated for malignancy. Most of these cases remain neglected because of inadequate evaluation and investigation by the local doctors which leads to late presentation. Due to these circumstances the patients have already metastatic disease at presentation. So, it is required to educate local doctors as well as general population to create proper awareness of this disease