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Background: Reproductive health (RH) communication between mothers and adolescent girls is critical for fostering knowledge and healthy behaviors. This communication varies significantly between urban and rural settings due to different socio-cultural contexts and access to information. The aim of this study was to compare RH communication with mothers between urban and rural adolescent girls. Methods: This cross-sectional comparative study was conducted from January to December 2020 in Mithapukur upazila (rural) and Rangpur city (urban) in Bangladesh. A total of 112 adolescent girls aged 14 to 17 from class 9 and 10 were interviewed, with 56 girls from each area. Results: Socio-demographic characteristics were similar in both groups. In both urban and rural areas, 67.9% of respondents communicated with their mothers about RH, while 32.1% did not. In the past six months, 58.9% of urban and 57.1% of rural girls had no RH discussions. Menstruation and pubertal changes were the most common topics in both areas, while other RH topics were less frequently discussed. Discussions often began at the onset of menstruation or between ages 9-12, with some starting during high school entry or initiated by the girls themselves, though 32.1% in both areas had not started discussions. The majority were only informed about necessary RH parts. Conclusions: The results of this study demonstrate that RH communication among urban adolescent girls was higher as compared to the rural adolescent girls.
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Background: The well-researched method of brachial plexus blocking is used in upper limb procedures. The blind paresthesia methodology used in the conventional approach has a greater failure rate and may cause damage to the tissues that surround and nerves. Peripheral nerve stimulators and ultrasound methods were used to better localise the nerve/plexus in order to prevent certain of these issues. Methods: A total of 50 patients were included in this prospective randomized trial and randomly assigned to two groups: US (Group US) and LM (Group LM) after receiving clearance from the institutional ethics committee and consent from the patients. Each of the two groups got 0.5% bupivacaine. The injection of local anaesthetic (bupivacaine, 2 mg/kg) did not exceed the hazardous dosage since the amount was determined based on body weight. Result: The demographic information for both groups was similar. When compared to ultrasound, the mean time required for the method to provide a block via inducing paraesthesia was much shorter. There was no statistically significant difference in the meantime of motor block start, sensory blockade, or the length of both types of blockades. The ultrasonic group had a higher block success rate than the traditional group, although this difference didn't prove clinically important. Conclusions: The most secure and effective approach to perform a supraclavicular brachial plexus block is using ultrasound guidance. Because ultrasonography allows for the transmission of local anaesthetic and instantaneous imaging of underlying structures, the incidence of problems is lower.
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The purpose of this scoping review is to employ Arksey and O’Malley’s scoping review methodology to determine leadership and management styles and their influence on health worker’s job satisfaction and productivity in Low-and middle-income countries. A scoping review of literature published in English since May, 2012 was carried out using PubMed, CINAHL, ScienceDirect, ProQuest and Sage. Key search terms strategy was employed using the words “leadership styles”, “management styles”, “health workers”, “productivity” and “job satisfaction” to identify relevant studies. A total of 1487 articles resulted from the application of the search strategy. Nineteen articles met the inclusion criteria of which 18 was quantitative and 1 was qualitative study. The main leadership styles identified were transformational leadership style, transactional leadership style, laissez-faire leadership style and autocratic leadership style. Transformational leadership style was found to have a higher influence on job satisfaction as compared to the other forms leadership styles. Also, transformational leadership styles encouraged about 67% of health workers to provide better healthcare services to their patients. Health facilities in LMICs have employed mainly transformational, transactional, participatory and laissez-faire leadership styles that have varying degree of influence on health workers job satisfaction. Transformational leadership style has proven to positively influence job satisfaction and productivity while laissez-faire leadership demotivate healthcare workers. In order to improve health care services and productivity for client as well as job satisfaction for healthcare workers, transformational leadership trainings will have to be intensified.
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Background: During coronavirus outbreak, lockdown was implemented in India and online teaching was adopted as new teaching method. This shifting in teaching pattern may increase the burden on mental health of school teachers and cause various mental health issues. Therefore, this study was done to assess stress and anxiety levels of teachers and impact of yoga intervention on them. Methods: An interventional study was conducted with teachers of five English medium schools. Pre-test was done for the assessment of stress and anxiety by using Perceived Stress Scale (PSS) and Generalized Anxiety Disorder 7 (GAD-7) scale respectively. Yoga intervention was done virtually once a week for three months. Participants were asked to practice the yoga daily on their own. After three months, post-test was done using similar questionnaire. Results: A total of 136 teachers were enrolled in this study. On pre-test, moderate perceived stress was observed in 95 (69.9%) participants. 38 (27.9%) participants were having mild anxiety symptoms and 74 (54.5%) participants were having no anxiety symptoms. Pre PSS mean score was 17.28 (SD=5.90) and Post PSS mean score was 13.29 (SD=4.30). Pre GAD-7 mean score was 4.88 (SD=4.28) and Post GAD-7 mean score was 4.24 (SD=3.13). There were highly significant mean differences between pre-post comparison of PSS and GAD-7 (p<0.001). Conclusions: The study showed significant level of stress and anxiety among teachers. Yoga intervention of three months was effective in reducing stress and anxiety levels in teachers.
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Background: The aim of the study was to determine the prevalence and factors associated with asymptomatic bacteriuria among pregnant women. Methods: A cross-sectional study was used to determine the prevalence of uro-pathogens among pregnant women attending Antenatal Clinic at Weija-Gbawe Municipal Hospital. The data was collected between May 2023 and October 2023. The data collection process involved the use of a structured questionnaire, while urine specimens were collected in sterile urine containers and cultured on CLED medium. The bacteria colonies were identified and evaluated for their susceptibility to antibacterial agents. Multiple logistics regression was used to determine the factors associated with bacteriuria among pregnant women. Results: The age range of the participants was 14 years to 45 years with mean age of 30 years (SD±6.5). About 13% of the participants had no formal education. Majority (77.4%) of study participants were obese while only 3.42% had normal weight. Isolates were Escherichia coli (27%), Klebsiella species (23%), Proteus species (18%) and Citrobacter koseri (18%). Gentamicin was sensitive to E. coli and cotrimoxazole was the most resistant antibiotics. Factors such as BMI, educational level, smoking status, recurrent UTI, parity were not found to have statistical influence on prevalence of bacteriuria among pregnant women. Conclusions: The study revealed 15.1% prevalence of ASB among pregnant women with E. coli being the predominate isolates. Gentamicin and cotrimoxazole were the most sensitive and resistant antibiotics respectively. Pregnant women should be advised to adhere to optimal hygiene practices and safe sexual behaviours, with a focus on the role of these practices in preventing uro-pathogen colonization.
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Background: Childbirth experience is an important event in every woman抯 life but there is lack of current research in this area in Bangladesh. For improving quality of care for pregnant women during childbirth, clinical care modalities should be designed to improve the experience of care by the mothers. The aim of the study was to assess the childbirth experience in regards to respectful maternity care, effective communication, companionship during childbirth and continuity of care. Methods: A cross-sectional study was conducted between January to December 2020 among 98 mothers during facility-based childbirth in one model district hospital and one existing district hospital situated in northern part of the country. Results: Mean age of the respondents was 23.2 years (+SD 5.0). Majority completed secondary education (53.1%), and their average monthly family income was 12081.63 taka (+SD 5469.08). Childbirth experience was not associated with socio-demographic status and educational background (P>0.05). This study presents data on physical abuse prevalence and consent refusal rates among respondents, stratified by age groups, educational levels, and monthly family income. Despite variations observed across demographics, statistical analysis, including chi-square tests with continuity correction, revealed no significant differences (P<0.05) in these outcomes based on demographic factors. Conclusions: More than half of the mothers experienced non consented care and around one fourth of mothers being physically abused during childbirth.
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Background: This study aimed to gather the clinicians� perspective regarding the use and prescription practice of dual combination oral anti-diabetic drugs (OADs) in type 2 diabetes mellitus (T2DM) management in Indian settings. Methods: A cross-sectional study was conducted by using a 29-item structured questionnaire covering factors considered, challenges, preferred indicators of glycemic control, continuous glucose monitoring (CGM) use, and strategies. Additionally, it explored clinicians' feedback and experiences with dual combination oral anti-diabetic drugs in T2DM management. Results: Seventy percent of clinicians observed improved adherence to dual combination therapy of OAD. The combination of dipeptidyl-peptidase 4 (DPP4) inhibitors and metformin was favored for early initiation and showed better tolerability within the first year according to 42% of clinicians. Approximately 63% of clinicians prefer vildagliptin + metformin for 40� year-old diabetics. The combination yields favorable outcomes: 21% in young, 14% in elderly, and 7% in long-standing diabetes cases. After 5 years, 37% of clinicians observed 40-50% of diabetics reaching an HbA1c goal of <7.0% with this combination. Clinicians choose glimepiride + metformin for treatment intensification based on its efficacy, cardiovascular (CV) safety, and fewer adverse events. These factors were collectively recognized by 66.54% of respondents. Conclusions: This study provided valuable insights into real-world clinical practices and preferences regarding dual combination therapy for diabetes management. Clinicians identified the fixed-dose combination of DPP4 inhibitors and metformin as the preferred choice and highlighted the effectiveness of glimepiride + metformin in overcoming treatment intensification challenges.
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Background: Predicting esophageal varices in cirrhosis using the measurement of splenic stiffness is an exciting area of study. Vein enlargement in the lower esophagus, known as varices, is a common symptom of cirrhosis caused by portal hypertension. These varicose veins are potentially fatal since they bleed easily. The present study aims to predict the OV in cirrhosis patients by splenic stiffness in and around this region. Methods: After receiving permission from the Institutional Ethics Committee, the study was performed. The present study authors measured splenic stiffness and liver stiffness by using FibroScan in 112 consecutive cirrhotic patients who met the inclusion criteria. Patients were also assessed by hepatic venous pressure gradient (HVPG), upper gastrointestinal endoscopy, liver stiffness, liver spleen diameter to platelet ratio score, and platelet count to spleen diameter ratio. Results: Among 112 patients enrolled, 64 patients had valid liver stiffness and splenic stiffness measurement, and 64 patients had EV (small, n=23 and large n=42). There was a significant difference in median liver stiffness (54.2 vs. 21.3 kPa, p<0.05), splenic stiffness (56.1 vs. 30 kPa, p<0.05), liver spleen diameter to platelet ratio score (6.3 vs. 2.7, p<0.05), and platelet count to spleen diameter ratio (798 vs 1,241, p<0.05) between patients with OV and those without OV. Conclusions: Non-invasive markers, such as splenic stiffness, may help identify individuals with cirrhosis who are at risk of having esophageal varices, especially large ones, and who are at risk of bleeding, the study's authors conclude.
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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is now widely accepted as a therapeutic modality for benign and malignant diseases of the pancreaticobiliary tree. Acute pancreatitis is the most common and feared complication of ERCP, associated with substantial morbidity and mortality. This study aimed to compare the incidence of post-ERCP pancreatitis in combined rectal indomethacin and sublingual nitroglycerin with that of rectal indomethacin alone. Methods: This was a randomized controlled trial conducted in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from July, 2019 to September, 2020. In this study, 100 hospitalized patients of >18 years age undergoing ERCP based on clinical indication and proper investigation were included. The study population was randomly divided into two groups - group A (patients who were given indomethacin suppository plus sublingual glyceryl trinitrate) and group B (patients who were given indomethacin alone). Results: In this study, we found that PEP developed in 11 out of 100 patients (11%). Post-ERCP pancreatitis developed in 2 (4%) in group A and 9 (18%) in group B (p=0.025), which was statistically significant. Mild PEP developed in none in group A and 4 (8%) in group B whereas moderate in 2 (4%) in group A and 3 (6%) in group B. Severe pancreatitis occurred in none in group A and 2 (4%) in group B (p=0.231) which was not statistically significant. Conclusions: This study showed that the combination of indomethacin suppository and sublingual GTN is superior to indomethacin suppository alone in preventing post-ERCP pancreatitis.
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Background: Adverse drug responses are serious public health issues worldwide. Pharmacovigilance (PV) is an important part of the healthcare system since it assesses, monitors, and discovers medication interactions and their consequences in humans. Objective were to assess knowledge and perception about adverse drug reactions (ADR) and PV among pharmacy and medical students. Methods: A cross-sectional study was conducted for pre-final year and final-year of pharmacy and medical students. Study conducted through semi structured questionnaires and a total 607 participants were recruited in this study. Results: A total 607 participants of pharmacy (52.5%) and medical (47.4%) from pre final (50.2%), final year (49.9%) students participated in this study. Pharmacy students had a significantly better overall knowledge of ADRs than medical students (p<0.05). The perception of pharmacy students regarding ADRs reporting and PV were significantly more than those medical student’s (p<0.05). In comparison to pharmacy students, a lack of knowledge of where and how to report ADRs was the main barrier that medical students perceived to ADR reporting (0.02). Conclusions: This study shows that compared to medical students, pharmacy students had better awareness of ADR reporting and shown good perceptions of PV. To enhance the knowledge of PV among healthcare students, an instructional intervention ought to be implemented.
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Background: Assisted reproductive technology (ART) is a set of medical interventions used to facilitate the conception process in couples suffering from fertility issues. ART encompasses several techniques, including ovulation induction (OI), artificial insemination, testicular sperm extraction (TESE), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). This current study aimed to analyze the correlation between psychological strength and difficulties among children born by ART and normally conceived (NC) children. Methods: The study was conducted in a longitudinal retrospective fashion, in Combined Military Hospital, Dhaka, Bangladesh, from December 2022 to June 2023. A total of 47 participants from the ART group and 50 participants from the NC group were selected as study subjects by purposive sampling technique. Data were gathered using a pre-designed questionnaire and analyzed using the statistical package for the social sciences (SPSS) version 23.0 computer program. Results: The age range of the study participants was between 2 to 4 years old. A majority of the participants were female (53.2%), hailed from middle-class families (59.6%), lived in urban settings (42.6%), and identified as Muslim (72.3%). In terms of illnesses, a small proportion experienced physical ailments (6.4%) and psychiatric conditions (10.6%). Conclusions: Despite persistent worries regarding the potential adverse developmental effects on children conceived by ART, research findings suggest that such children do not exhibit noteworthy physical, psychological, or developmental challenges when compared to those conceived naturally.
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Background: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, particularly in resource-limited settings. Understanding the awareness and practices of health personnel regarding COVID-19 is crucial for effective infection control and patient care. This study aims to assess the awareness of COVID-19 symptoms, complications, transmission methods, and preventive practices among health personnel in Sirajganj, Bangladesh. Methods: This descriptive cross-sectional study involved 260 health personnel from Shaheed M. Monsur Ali Medical College and the 250 Beded Sheikh Fazilatunnesa Mujib General Hospital, Sirajganj. Data were collected through a semi-structured questionnaire, focusing on COVID-19 awareness and practices. The study employed purposive sampling and face-to-face interviews for data collection. Results: The study found high awareness of COVID-19 symptoms, with 96.15% recognizing fever and 97.69% identifying loss of smell. Awareness of complications like respiratory failure (80.00%) and pneumonia (60.77%) was also notable. Preventive practices such as handwashing (98.08%) and mask-wearing (98.08%) were widely adhered to. However, 36.15% of participants reported being affected by COVID-19, indicating potential exposure risks. Conclusions: The study reveals a high level of awareness and adherence to COVID-19 preventive measures among health personnel in Sirajganj. Despite this, the infection rate among participants highlights the need for enhanced protective measures and continuous education. These findings can inform strategies to strengthen healthcare responses to ongoing and future pandemics.
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Molecular docking serves as a crucial computational tool in the realm of drug discovery and development, aimed at understanding the interactions between small molecules and target proteins. This abstract delves into the objective of elucidating the evolution of molecular docking techniques, their current applications, and potential future directions. Through a comprehensive review of the literature and analysis of recent advancements, this abstract provides insights into the methodologies employed in molecular docking studies. From the traditional rigid docking approaches to the more sophisticated flexible and ensemble docking methods, the evolution of techniques is discussed, highlighting their strengths and limitations. The past decade has witnessed significant strides in the field of molecular docking, with improvements in algorithms, scoring functions, and accessibility of computational resources. However, challenges persist, including accurate prediction of ligand binding affinities and consideration of protein flexibility. Additionally, the advent of hybrid approaches combining docking with molecular dynamics simulations presents exciting opportunities for more realistic modeling of ligand-protein interactions. In conclusion, molecular docking continues to be a cornerstone in structure-based drug design, facilitating the identification and optimization of lead compounds. Despite notable advancements, there remains a need for further refinement in docking methodologies to address current limitations and harness the full potential of computational techniques in accelerating the drug discovery process.
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Pituitary tumors are growths that form in the gland these tumors are rare representing 10-15% of all brain tumors. They can disrupt the production of hormones, in the body leading to symptoms related to hormone imbalance. This review offers an overview of the methods used for diagnosing and treating tumors. It is worth noting that relying solely on references may restrict the scope and depth of discussions about tumors in this paper. Suggestions for research include exploring diagnostic tools like molecular imaging and liquid biopsy to enhance early detection and accurate assessment of these tumors. Additionally, more research is required to understand the long-term effects and quality of life outcomes for patients undergoing treatment options for tumors. In conclusion, significant progress has been made in diagnosing and treating tumors over time. Advances in imaging technologies such as diffusion-weighted imaging and magnetic resonance spectroscopy have enhanced precision and treatment strategies for these tumors. The discussion also covers the roles of surgery, radiation therapy and medical interventions, in managing tumor growth and hormonal imbalances further advancements, in research and innovation are crucial, for enhancing our knowledge and treatment of tumors ultimately bringing outcomes for both patients and healthcare professionals.
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Background: Breast self-examination (BSE) is a preventive and easy way for people to keep an eye on the health of their breasts. People who routinely examine their breasts may be able to identify changes or abnormalities at an early stage, which may help in the early diagnosis of breast cancer. This self-care routine encourages an active approach to breast health and actively participate in their own well-being. Objectives of the study were assessment of the knowledge and attitude on breast self-examination among female college students, to assess the major barrier to perform breast self-examination, and to assess the impact of pharmacist mediated education program on breast cancer. Methods: This study is an interventional cross-sectional community based-survey. 1007 students’ female college students at Adichuchanagiri University in B. G. Nagar belonging to 18-33 years were chosen at random using stratified sampling. Knowledge, attitude on breast cancer. Data was analyzed using statistical package for the social science (SPSS) version 25. Results: In pre-test out of 1007 students 251 students had good knowledge about breast self-examination. In post-test 1006 members had good knowledge about breast self-examination. In our study statistical relation found between pre and post questionnaires (p=0.001). Conclusions: The study emphasizes how important it is to launch educational programs to increase awareness of breast self-examination. Additionally, awareness needs to be raised by removing known barriers. It is important to encourage women in the community to self-examine their breasts and to report any changes to a doctor as soon as possible.
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Background: Premature ejaculation is the most common cause of sexual dysfunction. There is no consensus on the treatment protocol due to poor understanding of the underlying mechanisms. Therefore, the present pilot study was conducted to compare the efficacy of topical eutectic mixture for premature ejaculation (TEMPE) spray with lidocaine gel for the treatment of premature ejaculation. Methods: After obtaining ethics approval and written informed consent, 100 patients meeting the inclusion and exclusion criteria were included. Baseline values of intravaginal ejaculation time (IELT) and international index of erectile function (IIEF) were recorded. Patients were randomly assigned into group A (lidocaine plus prilocaine spray) and group B (lidocaine gel). After 4 weeks of treatment IELT and IIEF score were recorded. The findings were noted and analysed. Results: Both the groups were similar in terms of demographic and baseline characteristics. There was a significantly higher improvement in IELT and IIEF score following treatment in group A as compared to group B. The incidence of side effects was lower in group A as compared to group B. Conclusions: We recommend that the use of TEMPE spray for the treatment of premature ejaculation as it is better than lidocaine gel.
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Background: Pain in the postoperative period is of particular concern. It is a major barrier in the uptake of circumcision. There are various systemic and local analgesics for the management of postoperative pain. However, data regarding efficacy is scarce. Therefore, the present pilot study was conducted to compare the efficacy of lidocaine and prilocaine spray with oral analgesics for the relief of pain. Methods: After obtaining ethics approval and written informed consent, 100 patients meeting the inclusion and exclusion criteria were included. After circumcision, patients were randomized into group A (Lidocaine and prilocaine spray) and group B (Oral analgesics). Pain was assessed by visual analogue scale (VAS) score and patient reported comfort levels were assessed in the postoperative period till 72 hours. Findings were noted and analysed. Results: Both the groups were similar in terms of demographic characteristics and baseline characteristics. The VAS score was significantly lower in group A and the patient-reported comfort level was significantly more in group A. Conclusions: We recommend that the lidocaine and prilocaine spray is better in relieving pain in the postoperative period following circumcision as compared to oral analgesics.
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Background: Benign prostatic hyperplasia (BPH) is common amongst the elderly. Even after transurethral resection of prostate (TURP), retention of urine may persist in some leading to significant morbidity adversely affecting the quality of life. The role of alpha blockers in this situation as a combination is unclear. The present study was conducted to evaluate and compare the efficacy of tamsulosin versus tamsulosin and deflazacort in relieving the postoperative retention of urine following TURP. Methods: After obtaining ethics approval and written informed consent, 72 patients satisfying the eligibility criteria were included. After TURP, patients with urinary retention following catheter removal were randomized into group A (tamsulosin hydrochloride) and group B (tamsulosin hydrochloride and deflazocort). baseline international prostate symptom score (IPSS) score was done to assess quality of life and findings of radiological investigations were noted. Thereafter, medical therapy was done as per assigned group and postoperative findings were documented and analyzed. Results: Both the groups were similar in terms of demographic characteristics and baseline characteristics. The relief of symptoms was significantly more in group B along with lower IPSS score and residual volume. Conclusions: We recommend addition of deflazacort to tamsulosin hydrochloride as medical therapy for the management of postoperative retention of urine (POUR), especially following TURP.
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Background: Hepatitis B virus (HBV) infection poses a significant health challenge in Bangladesh, with the hepatitis B core antibody (anti-HBc) being a crucial marker due to its lifelong presence in the bloodstream. This study aimed to evaluate the prevalence of anti-HBc (total) positivity among unvaccinated adults in Northeastern Bangladesh. Methods: This cross-sectional observational study was conducted in the Sobhanighat area of Sylhet, Bangladesh, in collaboration with the department of gastroenterology, Sylhet MAG Osmani Medical College, from November 2022 to August 2023. A total of 216 participants were selected using consecutive sampling. HBsAg, anti-HBs, and anti-HBc (total) were tested for all subjects, and data were collected using a pre-formed questionnaire and analyzed using statistical package for the social sciences (SPSS) version 24. Results: Among the participants, 16 (7.4%) tested positive for anti-HBc (total), while HBsAg was positive in 6 (2.77%) individuals. Anti-HBs was detectable in 23 (10.6%) participants, with 3 (1.38%) showing isolated anti-HBc positivity. Notably, 20% of HBsAg-positive cases exhibited heterotypic anti-HBs. Moreover, 56.25% of respondents with anti-HBc (total) positivity had detectable anti-HBs (p<0.001). Gender did not show significant associations with HBsAg, anti-HBc (total), anti-HBs, or isolated anti-HBc (p>0.05). Conclusions: The study underscores a notable prevalence of anti-HBc (total) positivity among unvaccinated individuals in Bangladesh, indicative of past HBV exposure. It underscores the necessity for enhanced vaccination coverage and robust infection control measures to mitigate HBV transmission in this demographic.
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Background: Retrograde intrarenal surgery (RIRS) is the standard of care for renal stones of less than 1.5 cm and less than 1000 Hounsfield units (HU). Most virgin ureters do not allow the flexible ureteroscope in the first setting. Placement of a D-J stent in the ureter dilates the ureter. Therefore, our study aimed to compare stone clearance rates and symptom complex of passive ureteral dilation following 4.5 French/Fr versus 6 French/Fr double J (DJ) stent placement. Methods: After obtaining ethics approval and written informed consent, 100 patients satisfying the inclusion and exclusion criteria were included and data recorded. patients were randomized into group A (4.5 Fr) and group B (6 Fr). Stent was placed. After 4 weeks, symptoms were assessed by the ureteral stent symptom questionnaire (USSQ). Following retrograde intrarenal surgery (RIRS) successful passage of ureteric access sheath (UAS) and stone clearance rates were assessed. Results: The surgical success rate, stone clearance rate was similar in the two groups (p value: more than 0.05). The USSQ score was significantly lower in group A (p value: 0.001). Conclusions: Stent of smaller diameter (4.5 Fr) is associated with less patient discomfort with similar surgical completion rates and stone clearance.