Applications and complications of subclavian vein catheterization for hemodialysis

To study the indications, complications and duration of 605 subclavian catheters inserted over a period of 4 years as venous access for the management of renal failure in local setup. Design: Cross-sectional descriptive study. Place and Duration of Study: Hemodialysis section, Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore. The study was conducted from October, 1998 to July, 2002. Subjects and All patients coming for dialysis during the period of October 1998 to July 2002 were included information noted on specific form. Among the patients who underwent subclavian vein catheterization, 75.2% patients were suffering from chronic renal failure and 24.7% patients were admitted for acute renal failure. Among chronic renal failure patients, 21.9% catheters had to be replaced due to various complications e.g. thrombosis, infection or kinking of the catheter. The subclavian catheters remained in place for a mean duration of 4 weeks. Early complications encountered were arterial puncture, inability to cannulate the innominate vein, hemothorax, puncture of thoracic duct, hemomediastinum, arrhythmias and pulmonary hematoma in 10.7%, 16.5%, 0.5%, 0.2%, 0.6% and 0.2% of patients respectively. Mortality attributed to the procedure occurred in 0.1% cases. Delayed complications included early infection in 15% catheterizations while delayed infection occurred in 39% cases. Percutaneous subclavian catheterization is valuable, relatively easy to learn and safe method with acceptable rate of complications for patients necessitating hemodialysis and no established permanent vascular access

Pneumatic lithortripsy for the management of ureteric calculi

To determine the efficacy of Swiss lithoclast in the management of ureteric calculi and complications encountered in lithoclasty. Design: A prospective observational study. Place and Duration of Study: Department of Urology, Lahore General Hospital, Lahore [October 1999 ' September 2001]. Subjects and Thirty ureteric stones [in 20 subjects] were treated over a 2-year period. Site, size and number of stones were noted in these patients. Swiss lithoclast, introduced through a ureteroscope, was used to break the stone. The Lithotripsy time was 30 min. Stone breakage was assessed by plain X-ray KUB or retrograde pyelography. Fragmentation was complete in 90% cases. At one week follow up, 90% of patients were stone-free and at 3 months follow-up 95% of patients had spontaneous passage of the fragments. Re-treatment was required in 5% cases. Mean hospital stay was 2.4 days. Complications [including both significant and minor] occurred in 25% of cases. Lithoclasty is safe, simple and effective procedure for ureteric calculi. However, complications of the procedure may prolong the usual 48 hours hospital stay seen in uncomplicated cases

Morphological pattern of male infertility - an experience at Lahore General Hospital, Lahore

This is a retrospective study carried on fifty patients undergoing testicular biopsy for work up of male factor infertility in the Department of Urology Lahore General Hospital, Lahore. The objective was to determine the predominant histopathological patterns in testicular biopsies .A clinically relevant classification was utilized. Of the total 50 patients studied, normal spermatogenesis was found in 38 percent of cases. Hypospermatogenesis was found in 12 percent of cases, maturation arrest in 10 percent, germinal aplasia in 18 percent and end stage testis in 22 percent of cases. A higher percentage of germinal cell aplasia and end stage testis was seen in this study. The sample size, design of different studies and criteria used for patient selection explain the cause of observed differences