Primary neuroendocrine tumors

To evaluate clinical presentation and surgical out come of primary neuroendocrine tumors of Kidney, U. bladder and Prostate gland. A Retrospective study. Urology Department, SMBBMU Larkana. 2001-2011. Series of 6 patients of primary neuroendocrine tumors of Kidney, U. bladder and Prostate gland were identified from 1890 cases of urinary tract tumors. Two cases of renal carcinoid, two cases of small cell carcinoma of urinary bladder and two cases of small cell carcinoma of prostate glands. Renal carcinoid tumors presenting with lumbar pain and microscopic haematuria and identified on the ultrasound. Small cell carcinoma of urinary bladder presenting with dysuria, gross haematuria and on ultrasound while small cell carcinoma of prostate gland presenting with irritatory and obstructive symptoms and confirmed on DRE. 6 patients [5 male and 1 female],Mean age of patients were 45years and range was 35-55 years. All patients treated primarily by definitive surgery like Radical Nephrectomy, TURBT and Pallitive TURP and all tumors confirmed on histopathological examination and referred to LINAR Larkana for proper managements. primary neuroendocrine tumors of Kidney, U.bladder and Prostate gland are rare tumors. Carcinoid tumors have good prognosis but small cell carcinoma have poor prognosis so require prompt treatment

HDV infection in HBV infected individuals

To determine the status of HDV infection in HBV infected individuals at Larkana. This is a laboratory based retrospective study conducted at Molecular Laboratory PHCP-CMI Central laboratory CMC Hospital City block Larkana from October 2010 to September 2011. During the study period all the serum samples in which the HBV DNA was qualitatively detected were further processed for HDV RNA detection by the method of Real time PCR. During the study period a total of 1564 HBV DNA detected serum samples were processed for HDV RNA detection. The males were 1078 [69.0%] and females 486 [31.0%]. The age were ranged between 15 to 73 years. Out of the 1564 HBV DNA detected serum samples, the HDV RNA was detected in 865 [55.31%] and not detected in 699 [44.69%] individuals. This study showed 55.3% HDV infection in the HBV infected patient. Hence, to formulate the treatment option and to predict the response of treatment it is necessary that every HBV infected case should be processed for HDV RNA detection

Experience of upper urinary tract stones with dornier mpl 9000 lithotripter

To report our experience with Dornier MPL9000X Lithotripter in terms of safety, efficacy and complications in the management of upper urinary tract stones. Retrospective study. From 19[th] April 1998 to 15 August 2007 in the department of Nephrology, Chandka Medical College, Larkana. All patients who had renal calculi up to 2.5cm in size were selected for extra corporeal shock wave lithotripsy with Dornier MPL 9000 on the basis of clinical examination, laboratory investigations, X-Ray, intravenous urography and ultrasonography. Simple analgesics /sedation were used before the procedure, except in children where general anesthesia was used. A total of 1965 patients were treated with 3930 sessions [Average 4.1 sessions per patients]. Male to female ratio was 1.8:1. Average age of the patients was 35.3 years. The average stone burden was 1.8cm in diameter. Stone did not break in 3.3% cases, where as in 53 [2.69%] cases partial fragmentation had occurred. Over all success rate was 84%. About 10.2% cases were lost to follow up. Complications like colic pain, transient haematuria and stein Strasse was observed in 33%, 17% and 2.5% respectively. Extra corporeal shock wave lithotripsy for renal calculi was simple, safe and effective in selected group of patients

Acute renal failure: An experience at nephro-urology department Chandka Medical College Hospital Larkana

To find out the various causes of acute renal failure [ARF] and its out come in our setting of tertiary Care Hospital in rural areas. A retrospective Study. Nephro-urology department Chandka Medical College teaching hospital Larkana. From March 1998 to March 2005. Review of 294 patients of acute renal failure admitted in Nephro-urology department Chandka Medical College teaching hospital Larkana. Detailed history, physical examination and laboratory data of 294 consecutive patients of acute renal failure were analyzed. 294 patients were included in this study. Among them 149 [51.7%] were in the younger age group [less than 40 years] with dominance of males [1.61 to 1.00 male to female ratio]. Major cause of ARF was pre renal, seen in 172 [66.6%] patients, 70 [23.8%] of all cases of acute renal failure had gynecological and obstetrical back ground. Other causes C.V.A in 24 [9.3%], HHD in 14[4.5%]. Glomerulonephritis in 22[8.5%],and obstructive uropathy in 16[6.2%]. 92 Patients [31.3%] improved on conservative treatment,166[56.5%] needed dialysis and 36[12.2%] left against medical advice. This data reveals that pre renal element is the single most important cause of acute renal failure, in which commonest cause was pregnancy related ARF followed by C.V.A,HHD, glomerulonephrits and obstructive urophathy. Early indentification, referral treatment of pre renal factors, good peri natal care and good therapeutic measures substantially bring down the incidence of acute renal failure. 12.2% patients left against medical advice due to heavy expenses on the treatment and needs NGOs and Government support for treatment of poor patients

Pregnancy related acute renal failure; an experience at nephro-urology department Chandka medical college teaching hospital Larkana

Acute renal failure [ARF] during pregnancy is rare event and continues to be common in developing countries. 1998-2005. Nephro-urology unit at Chandka Medical College, Larkana. Retrospective study. 294 cases of Acute Renal Failure were treated. Among these cases, 72 [24.5%] were pregnancy related in origin. All of these patients were known to be previously healthy. Pregnancy related Acute Renal Failure was associated with, post partum hemorrhage was in 20 [27.7%], intra intiauterine death in 20 [27.7%] antipartum hemorrhage was 18 [25%], preeclampsia-eclampsia in 8 [11.11%] and septic abortion and puerperal sepsis in6 [8.3%]. Among these patients 65 [90.3%] required dialysis therapy because of moderate to severe azotemia. 35 [48.61%] patients recovered normal function. 30 [46.15%] developed irreversible renal function. Early reorganization of this disorder, improvement of health infra structure, antenatal health care and intensive supportive therapy, can reduce maternal and fetal mortality and morbidity

Ultrasound guided percutaneous nephrostomy: 6 years experience

To assess the safety, success rate and complication of percutaneous nephrostomy tube [PNT] insertion for the relief of obstructive uropathy. From 1999 to 2005, 465 PNT insertions were performed at the Urology Department Chandka Medical College Teaching Hospital Larkana and Urology and Dialysis center Dadu. Among 430 patients, 300 men and 130 female, age ranged from 12 to 69 years. PNT placement was performed under local anesthesia during regular working hours. Early complications within 15 days of PNT insertion were recorded. Of the 430 procedures, successful PNT insertion was recorded in 400 [93%]. Follow-up data up to 15 days was available in 385 placements [96.2%] of which major immediate complications were encountered in 22 [5.7%] patients. and minor complications seen in 24[6.2%] cases. Ultrasound guided PNT insertion is safe with high success rate and should be procedure of choice for relief of obstructive Uropathy