Semirigid ureteroscopy with pneumatic lithotripsy for ureteral stone.

BACKGROUND: Ureteral stones present with acute loin to groin pain. The objective of this study is to find out the outcome and safety of semi-rigid ureterscopy with pneumatic lithotripsy for treatment of ureteral stones of >30 mm(2) and to assess the impact of size and location on stone free (SF) rate. METHODS: Total 110 patients with isolated ureteral stone size>30 mm(2) were included in this study and treated with pneumatic lithotripsy using 8/9.8 Fr. Semi-rigid ureteroscope (Stiema Germany). Stones were fragmented into 2-3 mm particles and removed. Outcome parameters assessed at 3 months follow up were stone free rate(SF),Efficiency Quotient (EQ), and impact of stone size and site on SF/EQ was also analyzed. Similarly, patient demographics, procedures, patient related parameters and complications were also noted. RESULTS: The overall SF rate at 3 months follow up was 69.33% and efficient Quotient (EQ) 52.52%. The SF/EQ for upper, middle and lower third of ureteral stone was 55/37.67, 61/43.57, 92/84.40 respectively (P-value< 0.001). The SF for stone size 30-110 mm(2) and >110 mm(2) was 78% and 67% respectively. There were no major complications seen. Overall minor complication rate was 5.45 % (minor ureteral perforations-5, urinoma formation 1). CONCLUSIONS: Semi-rigid ureteroscopy with pneumatic lithotripsy is a safe, simple and effective procedure for ureteral stones with excellent success rate for distal ureteral stones. The stone free rate and EQ are statistically significant (P value<0.001) between upper, middle and lower ureteral stones. Stone size has a direct impact on the SF rate and EQ.

Diagnosis of multiple myeloma by demonstration of M protein in bone marrow aspirate by agar gel electrophoresis: a case report.

A number of laboratory tests are used to confirm the diagnosis of multiple myeloma, including M protein in the serum. Since M protein in the serum originate from tumour cells in the bone marrow before circulating in the serum, demonstration of M protein in bone marrow aspirate can be added to the batteries of diagnostic parameters.

Association of lipid profile and body mass index (bmi) in hypertensive patients of Eastern Nepal.

Dyslipidemia is closely associated with hypertension. Out of different fractions of lipoprotein, definite association of elevated LDL-Cholesterol (LDLc) and other lipid parameters has been well observed in hypertensive patients. The present cross sectional study was undertaken at BP Koirala Institute of Health Sciences with the aim to find out association of different lipid parameters and Body Mass Index (BMI) among newly diagnosed hypertension without any medications in Eastern Nepal. 80 hypertensive patients fulfilling JNC-7 criteria and 80 healthy controls were enrolled in this study. Lipid parameters (TC, TG, LDLc, VLDLc, HDLc) were estimated by Enzymatic Colorimetric test. Quetlet's formula was used to calculate BMI. Results were analyzed with student's 't' test and Pearson correlation analysis. Mean age of patients and controls were 36.30 +/- 7.73 yrs & 32.13 +/- 7.21 yrs respectively. There was significant increase in different lipid parameters namely TC (170.18 22.53 vs 145.23 21.13,P<0.005), TG (146.60 53.87 vs 119.77 35.61, P<0.005), LDLc (100.71 23.74 vs 79.25 20.10,P<0.05) and VLDLc (29.32 1077 vs 23.92 7.12, P<0.05) in patients as compared to the healthy controls. However there was no any significant difference in HDLc value. Pearson correlation analysis shows positive correlation of BMI with all the four lipid parameters even though it was not statistically significant. Thus this study shows direct association of BMI, dyslipidemia in hypertensive patients of the Eastern Nepal.