comparative study of percutaneous suprapubic cystolitholapaxy versus open cystolithotomy in children

To compare the outcome of percutaneous suprapubic cystolitholapaxy with open cystolithotomy in children. Comparative study. Department of Urology and Surgery, Peoples Medical College Hospital Nawabshah, from 2004 to 2007. Hundred patients [87 boys and 13 girls], from 1 to 10 years of age were enrolled in the study. The size of stones ranged from 8mm to 25mm. Patients were divided in two equal groups A and B. Group A submitted for percutaneous suprapubic cystolitholapaxy and group B for open cystolithotomy. The procedure was done under spinal and caudal anesthesia with intravenous sedation. To compare the outcome of percutaneous suprapubic cystolitholapaxy with open cystolithotomy Postoperative complications noted in group A patients included transient hematuria in 2 cases [p 0.495]. Operative time in group A was 10 to 15 minutes while in group B it was 25 to 40 minutes [p 0.0005]. Urinary leakage [n=2 - p 0.495] and wound infection [n=3 - p 0.242] were observed in group B. Duration of catheter placement was 2-3 days in group A, while 5 to 7 days in group B [p 0.0005]. Hospital stay of group A was 2-3 days while 5-7 days in group B [p 0.0005]. All patients became stone free. Percutaneous suprapubic cystolitholapaxy is an efficient, safe, minimally invasive and cost effective method

Breast carcinoma in Karachi. Clinical and pathological features

To evaluate the clinical presentation and morphological features of carcinoma Breast. A retrospective analysis of 50 patients that presented with Ca Breast over a period of three years in the surgical department of Lyari General Hospital and Civil Hospital Karachi. Most of the patients were in the 5th and 6th decade of life. The mean age at diagnosis was 48 years. The most common presentation was lump in the breast, out of which 12 were in left breast and 38 in the right breast. Location of lump indescending order; 18 in upper outer quadrant, 8 in outer lower quadrant, 5 in areolar reglon 3 in inner upper quadrant, 4 in inner lower quadrant, 10 patients presented with concomitant axillary lymphadenopathy, 2 with skin infiltration and distant metastatis. FNAC and Mammography correlated with H/P in 93% of cases. The most common tumor was infiltrating ductal carcinoma 81%. Tumor size was > 2 cm in 75% of cases. The number of cases with> 3 lymph node metastasis was significantly higher 70% in tumors of >2cm size. In Pakistani females breast carcinoma occurs at a younger age group. Due to unawareness, they are of large size at the time of presentation and show more frequent lymph node metastasis. Infiltrating ductal Ca is the most common type of tumor with predominance of high grade lesion

Cryptorchidism in adults

To evaluate the causes of late presentation in our population Cases presenting with cryptorchidism above the age of 14 years from January 2000 to December 2004, that got operated at surgical unit V and Lyari General Hospital were studied. Twenty six patients operated in the above mentioned institutes were included in the study. All male patients with of age 14 years or above with empty scrotum admitted in surgical wards through All patients with retractile testes were excluded from the study. Patients were admitted after proper diagnosis and clinical examination i.e either swelling or empty scrotum. In impalpable testes apart from base line investigation i.e U/S abdomen was also done. In case of bilateral undescended testes hormonal assay of HCG, FSH and LH were also carried out. 16 patients[57%] of the patients didn't present due to ignorance. 8 patients[29%] had consulted a rural practioners or quack; and were not guided further, other 4 patients[14%] did not present due to shyness. Three patients with bilateral cryptorchidism had infertility. This present study revealed that many treating rural practioners, quacks and paramedics were equally responsible for the late presentation of the patients. There is a need for thorough physical examination following birth by attending obstetrician, pediatrician and other practicing physicians. An advice for early corrective surgery will go a long way in reducing the complications due to late presentation