Outcomes of initial 100 cases of laparoscopic nephrectomy at tertiary care center (PKLI).

Objective: Laparoscopic nephrectomy has been adopted by many centers in the last few decades. However, there are a few inherent challenges while adopting laparoscopic nephrectomy in a new unit. These include a significant learning curve required to adopt this modality. This study aimed to share the initial experience of adopting laparoscopic nephrectomy at our center. Methods: In total, 101 patients were analyzed in the study. These patients underwent laparoscopic radical or simple nephrectomy (for renal mass and noncancer renal cases respectively) at Department of Urology, Pakistan Kidney and Liver Institute and Research Centre, Lahore from April 2018 till January 2021. Data were entered in the statistical analysis software file. Analysis was attained by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized in the case of the continuous variables. While frequency/percentages represented categorical factors. Results: The mean age of patients was 42.81±15.49 years and their overall BMI was 26.41±5.30 kg/m2. Out of these, 57 (56.43%) were males and 44(43.56%) were female. Eighteen percent of patients had a previous surgical history on the ipsilateral side. Total operative time was 163.98±58.02 minutes while mean hospital stay reached 3.2±0.87 days. The tumor-free margin was attained in all cases of radical nephrectomy. Based on Clavien-Dindo classification, Grade-1 (n=3; 2.97%), Grade-2 (n=6; 5.94%), Grade-3A (n=1; 0.99%), and Grade-3B (n=1; 0.99%) complications were observed. Conclusion: In a newly developed urology center, laparoscopic nephrectomy can be a daunting task. Good teamwork among the surgical team members and careful selection of cases can result in satisfactory procedural outcomes.

Efficacy of locally produced Latanoprost in the control of intraocular pressure in patients with primary open-angle glaucoma.

PURPOSE: To determine the efficacy of locally produced Latanoprost in reducing the intraocular pressure (IOP) in patients with Primary open-angle glaucoma (POAG). DESIGN: Open-label, non-comparative, observational case study with non-probability purposive sampling. METHODS: A total of 48 patients (94 eyes) of either gender were recruited from glaucoma clinic with the diagnosis of POAG, having IOP of more than 21 mmHg. Patients were commenced on locally produced Latanoprost (Vislat 0.005%). IOP was subsequently measured at 4 weeks and 12 weeks, respectively. The primary end point was reduction in IOP at 12 weeks after the initiation of treatment. RESULTS: A total of 48 patients (94 eyes) were recruited from glaucoma clinic. The average IOP of our patients at baseline was 28.6 ± 8.1 mmHg, decreasing to 21.3 ± 10.6 mmHg at 4 weeks, indicating a drop of 19.1% (P < 0.001). IOP further decreased to 20.3 ± 8.7 mmHg after 3 months of treatment indicating a decrease of 23.3% (P < 0.001). A decrease in IOP occurred in 51 eyes (71.8%) at 4 weeks after treatment, improving to 54 eyes (76%) at 3-month follow-up. Twenty eyes (28.1%) did not show any change in IOP at 4 weeks. However, after 3-month follow-up only 17 eyes (23.9%) did not reveal any change in IOP. CONCLUSION: Our results showed a decrease in IOP of 19.1% after 4 weeks, increasing to 23.3% at 12 weeks in cohort of 37 patients (72 eyes) treated with locally produced Latanoprost (Vislat 0.005%).

Ultrasound Diagnosis of Penile Fracture.

A rare but possibly underreported urological emergency is penile fracture which results from tear in the tunica albuginea of the penis. The proposed etiology is forceful manipulation of an erect penis or secondary to blunt trauma. We would like to report a case of young patient presenting with large penile shaft hematoma and deformity. The patient did not provide obvious history of trauma or sexual intercourse. The ultrasound of penis was performed which suggested the diagnosis of penile fracture and ultrasound findings were correlated with peroperative findings.

Chlamydia trachomatis related knowledge and practices in medical practioners--a survey.

INTRODUCTION: Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns. METHODOLOGY: The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013). Inclusion criteria included all medical practitioners working at those hospitals and there were no limitations of age and gender to participate. The participants were approached through email which included a self administered questionnaire. Written consent was obtained from the participants and the study was approved by the ethical committee of all selected hospital. RESULTS: Overall 130 participants participated with a response rate of 65%. Females were 52.3% and males were 47.7%. In the study 17.7% of male and 29.4% of female participants proclaimed that they referred a patient to an infectious disease specialist in case the diagnosis of Chlamydia was dubious. 72.5% of the male and 55.8% of the female medical practitioners indicated that they yield detailed sexual history from the patients with Chlamydia. Regarding inquiring about the drugs history from the patient at risk of STDs, 22.6% male and 35.3% of female participants informed that they took a detailed drug history. Only 1.5% of the female medical practitioners notified Chlamydia to the partner of diseased patient themselves (provider referral). 24% male and 17.6% female participants had an understanding regarding the definite test of diagnosis for sexually transmitted Chlamydia. CONCLUSION: More sexual health skills development is required in medical practitioners working in Pakistan. The major deficient areas are sexual and drug history taking, management of sexually transmitted diseases and partner notification.