Penile emergencies: two years experience at our centre

Background: Many men with penile injuries opt out of medical treatment for ethical or psychological reasons, which means the true incidence is likely substantially lower than reported. Urgent medical attention is usually required for acute penile illnesses, which are rare but serious. A vascular, viral, or trauma-related event is usually to blame. Methods: The study was carried out at Narayana medical college in Nellore for a duration of two years, from January 2022 to April 2024.There were four groups vascular group with priapism and spontaneous penile gangrene (n=9) and those with penile fractures, degloving injuries, amputations, and entrapment (n=16) were part of the infected group, whereas patients with penile myiasis were part of the trauma group. The last group consisted of four patients who had paraphimosis. Results: The results showed that 60% of patients who had penile fractures within 6 hours presented for treatment. Every single patient has a torn tunica and one of them even has urethral involvement. Idiopathic causes 62.5% of the eight cases of priapism, and 37.5% of patients presented within six hours. Aspiration with intra-cavernous phenylephrine was the. If they fail to respond, employ the grey hack and water shunt techniques. Conclusions: The incidence of penile injuries is underreported; patients may appear to healthcare providers far later than necessary, and this is largely attributable to psychological and ethical factors, such as shame and fear. However, early and rapid management led to better outcomes.

A comparative study of morbidity and symptom severity among double-J stented patients with and without tamsulosin administration

Background: The insertion of a double-J (DJ) stent is considered a routine and necessary urological procedure. The symptoms produced by the stent are predominantly irritative in nature and the use of alpha blockers like tamsulosin have shown considerable in treating the stent associated symptom. Aim of the study was to assess tamsulosin's impact on ureteral stent-associated morbidity. Methods: A comparative cross-sectional study. All the patients with ureteric calculi admitted in the department of urology, Narayana Hospital, Nellore, Andhra Pradesh. Results: A total of 80 patients who met the inclusion criteria, were divided into two groups. Group A receiving placebo and group B receiving tamsulosin 0.4 mg. Among the study population, there was statistically significant difference between the means of parameters between the groups during the stent removal. The means of group B were significantly lower than the means of group A which shows that tamsulosin is very effective in managing the pain and also the stent related morbidity. Conclusions: Tamsulosin is very effective in managing the pain and also the stent related morbidity, which was measured by international prostate symptom score (IPSS) score – both obstructive and irritative. The quality of life was suggestively better in tamsulosin group.

Case series to study the clinical features, risk factors, prognostic factors, and to assess the different management modalities of EPN and its outcomes

Background: Emphysematous pyelonephritis is an acute necrotising infection of the kidney, often associated with high rate of renal loss and mortality. EPN mostly present with triad of fever, flank pain and nausea. The diagnostic tool of choice is CT KUB. E. coli is the most common pathogen. Methods: It was prospective study done on 52 patients who were diagnosed to have EPN from department of nephrology and urology in Narayana Medical College, Nellore from March 2022 to January 2024. The diagnosis of EPN was confirmed by plain CT KUB scan. Results: Among 52 patients 48 patients had diabetes mellitus (DM). left kidney involved in 28 patients and right kidney involved in 16 patients and bilateral kidney involvement in 8. Fever (92%), flank pain (88%) are the most common presentation in patients. Shock during initial presentation was seen in 19.5% of patients. E. coli growth was seen in 26.9% cases. 8 patients were treated conservatively with antibiotics according to culture and sensitivity. 32 patients required double J stenting, 7 patients required percutaneous nephrostomy. Nephrectomy was done in 5 patients. Mortality rate in our study was zero. Conclusions: Nephrectomy should be promptly attempted for patients not responding to conservative methods. Pre-existing CKD status, shock at presentation and altered sensorium are the factors determining the prognosis and management.

Laparoscopic ureterolithotomy: a rare case report

In this era of endourology most of the ureteric calculi are managed by endourological technique. However, lap ureterolithotomy has a role in the management of large ureteric calculus with minimal complications, morbidity, early recovery and short hospital stay. Laparoscopic ureterolithotomy bridges the gap between open and endourologic procedures as it is minimally invasive and overcomes a few of the disadvantages of open ureterolithotomy. We report a case of our experience of impacted upper ureteric calculus done by laparoscopy. Here we present a case of 45 -year-old male with right loin pain with CT suggestive of impacted right upper ureteric calculus measuring 2.2󪻒.2 with moderate HDUN and good renal function. Patient underwent right transperitoneal laparoscopic ureterolithotomy and, the ureteric calculi was removed successfully. Hence, we can conclude that, laparoscopic uretrolithotomy is safe for large impacted ureteric calculus with early recovery and minimal morbidity to the patient with complete clearance.

Single puncture percutaneous nephrolithotomy for large staghorn calculus: experience at a tertiary care center

Percutaneous nephrolithotomy (PCNL) is recommended procedure for stones greater than 2 cm This procedure is being used commonly by all urologists worldwide. With increasing using of imaging studies, the incidence of large staghorn calculus has been consistently decreasing because most of the stones are being detected while they are still small. In this case report we are presenting a case of a large staghorn calculus of size 6.7×5.2 cm which was completely cleared by PCNL with a need for relook procedure.

Single puncture percutaneous nephrolithotomy for large staghorn calculus: experience at a tertiary care center

Percutaneous nephrolithotomy (PCNL) is recommended procedure for stones greater than 2 cm This procedure is being used commonly by all urologists worldwide. With increasing using of imaging studies, the incidence of large staghorn calculus has been consistently decreasing because most of the stones are being detected while they are still small. In this case report we are presenting a case of a large staghorn calculus of size 6.7×5.2 cm which was completely cleared by PCNL with a need for relook procedure.

Proportion of Genu Valgum and Genu Varum in Students Aged 19-25 Years

Background:Knee joint mal alignments are divided into genu valgum and genu varum. The presence of these mal-alignments leads to complications like tibio-femoral osteoarthritis, compensatory changes in ankle/foot, etc.Taking a community of physiotherapy students, the proportion ofgenu varum, genu valgumand its association with body mass index (BMI) and foot posture index (FPI) was investigated. The aim of the study was to evaluate the proportion of genu valgum and genu varum in subjects aged 19 -25 years.Materials and Methods: The data was collected from D.Y. Patil University, Navi Mumbai. A consent form and a validated proforma was used. Age, BMI, FPI, IKD (Inter-knee distance), IMD (Inter-malleolar distance) and Q-angle was recorded, and the data was statistically analysed.Results: 45 out of 100 females had genu valgum which was found to be associated with higher BMI and pronated feet. 9 out of 100 females had genu varum which was found to be associated with lower BMI. Chi-square test was done to find out these associations.Conclusion: Awareness of the proportion of angular mal-alignment in knee would increase the recognition of this problem among the individuals and doctors for better execution of strategies that can help avoid these mal-alignments.

Management of spinal tuberculosis--current concepts.

Evidences of spinal tuberculosis have been found in Egyptian mummies and the disease is one of the oldest diseases afflicting humans. The demography, diagnosis, medical and surgical treatment, as advocated currently, have been reviewed with a brief discussion of the literature. Early diagnosis and comprehensive treatment are needed to control this public health problem.

Prevalence of fragile X(A) syndrome in mentally retarded children at a genetics referral centre in Delhi, India.

The usefulness of the clinical score based on Turner 5-trait scale prior to undertaking cytogenetic or molecular tests for the diagnosis of the fragile X(A) syndrome was evaluated. Mean clinical score in fragile X positive patients was significantly higher than in fragile X negative patients (7.06 +/- 1.85 vs 2.98 +/- 1.6, P < 0.0001). Of 1206 children with mental retardation 360 (29.8%) boys fulfilled defined clinical criteria to be screened for fragile X syndrome by chromosomal studies. Twenty three (6.38%) of them were found to be positive for fragile X syndrome using cytogenetic techniques. Molecular confirmation in 21 affected boys (two were lost to follow up) showed full mutation in 19 (5.27%). Two patients showed a normal 5.2 kb band on southern blot. This frequency (5.27%) of fragile X(A) patients among children with non-specific mental retardation is comparable to the results of studies in the West. Routine use of the clinical score, and the selection of patients with a score > or = 5 for diagnostic tests would reduce the laboratory load, especially in countries with limited facilities.

A clinical and cytogenetic study of Turner syndrome.

Forty five case of Turner syndrome diagnosed in the Genetics Clinic, between January 1986 and December 1993, were analyzed. The most commonly observed karyotype was 45, X (44.4%), followed by 45, X/46, XX mosaicism (24.4%). Less frequently demonstrated karyotypes were 45, X/46, X, i (Xq) mosaicism and 46, X, i (Xq) (13.3%). Mosaicism for chromosome was seen in 6.7% of patients. Patients with 45, X karyotype had short stature (85%), dysmorphic facies (60%), delayed appearance of secondary sexual characters (100%) and primary amennorhea (100%). Those with 45, X/46, XX mosaicism were less often dysmorphic and presented with either primary or secondary amenorrhea. Patients with 45, X karyotype were younger at diagnosis and had a significantly shorter mean adult height than those with 45, X/46, XX mosaicism. The phenotype in patients with other karyotypic abnormalities was similar to the 45, X group. Short stature and primary or secondary amenorrhea occurring together in a female strongly suggests the possibility of Turner syndrome, which should be confirmed by chromosomal analysis.

Purification and characterization of E. histolytica antigen for diagnosis of amoebiasis.

Entamoeba histolytica soluble crude antigen was fractionated by gel filtration on Sephacryl S-300 into four fractions, viz. F1(669 kDa); F2(51.2 kDa); F3(25.1 kDa) and F4(10.5 kDa). F1 fraction was observed to be more sensitive and specific for the detection of antibody in amoebiasis than the crude and other fractions of purified antigens employing IHAT and ELISA. ELISA was found to be better than IHAT since it could detect antibody in the sera (3/6) of asymptomatic cyst passers. The cross reaction of crude antigen with toxocariasis (1/4) and toxoplasmosis (2/5) sera were associated with F4 fraction. F3 and F4 were having low molecular weight and were not sensitive in detection of antibody in amoebiasis. Biochemical characterization revealed glycoprotein nature of the specific (F1) antigen fraction.

Development of simple and stable ELISA for detection of copro antigen in intestinal amoebiasis.

A simple, sensitive and stable ELISA (enzyme linked immunosorbent assay) was developed using rabbit antibody to fractionated Entamoeba histolytica antigen for the detection of copro antigen in the faeces of individuals with intestinal amoebiasis. In this test none of the healthy individuals, all trophozoite positive, 40% cyst passers and 6% individuals living in endemic area showed the presence of copro antigen. ELISA using polyclonal rabbit antibody could detect 1-5 trophozoites/well and 20-50 ng protein per well of NIH-200 strain of E. histolytica and the sensitivity of the test was comparable with that using monoclonal antibody. Cross reaction was observed only with E. invadens when faeces having other parasites were screened. The reagents of ELISA were stabilized and found to be stable for more than 6 months when stored at 4 degrees C.