Renal endometriosis mimicking a renal tumor in a pregnant patient.

Renal endometriosis, if progressed is a serious localization of disease burden that can lead to urinary tract obstruction, with subsequent hydronephrosis leading to potential kidney loss. Diagnosis is elusive and relies heavily on clinical suspicion as endometriosis can occur with both minimal and extensive disease. Management technique varies but the goal is to salvage renal function and disease burden.

Classical prone percutaneous nephrolithotomy in a solitary functioning kidney with severe kyphoscoliosis.

Percutaneous nephrolithotomy (PCNL) is one of the important options in the management of large (>2 cms) and complex renal calculi. Traditionally the prone position has been used to access the pelvicaliceal system. It has its advantages and disadvantages as well. Several modifications to this position have been suggested and reported by several urologists. We had performed PCNL in an elderly female in classical prone position with severe kyphoscoliosis and solitary functioning kidney.

Nosocomial uropathogens and their antibiotic sensitivity patterns in a tertiary referral teaching hospital in Rawalpindi, Pakistan.

BACKGROUND: Nosocomial urinary tract infections (NUTIs) are by definition not present at admission of a patient and are acquired during hospitalisation. The objective of this study was to study the uropathogens and their antibiotic sensitivity patterns in hospital acquired urinary tract infections presenting in a teaching hospital. METHODOLOGY: It was a retrospective descriptive study carried out at the Department of Pathology, Fauji Foundation Hospital, Rawalpindi, Pakistan, during the year 2009. Reports of urine culture and sensitivity performed during one year were retrospectively studied with a view to document various isolates and their antimicrobial sensitivity. RESULTS: Out of a total number of 1204 urine cultures submitted, 246 were found to have nosocomial urinary tract infections. Over all prevalence of nosocomial urinary tract infection in the examined reports was 20.43%. CONCLUSION: Nosocomial Urinary tract infections are common. Gram negative bacilli are most frequent uropathogens and are resistant to commonly used antibiotics. Fosfomycin followed by Gentamycin and Cefotaxime were the most effective antibiotics.

Frequency of otitis media in patients of nasal polypi.

BACKGROUND: Otitis media is a common disease encountered in ENT practice. Its incidence has fallen in the developed world. It is expected that nasal polypi causes Eustachian tube dysfunction which in turn leads to negative middle ear pressure causing to develop otitis media with effusion or recurrent otitis media. The objective of this study was to find the frequency of Otitis Media in patients of nasal polypi. SUBJECTS AND METHODS: It was a cross-sectional study. Seventy patients with bilateral nasal polypi were taken for study from OPD of ENT Department, Fauji Foundation Hospital Rawalpindi. Purposive (non-probability) sampling was done keeping p=4%. There were 24 (34.3%) males and 46 (65.7%) females included in the study. Age range was 26-38 years. Tympanometry was done in every patient to look for signs of Otitis media. Duration of study was from 24th Apr 2008 to 30th Jul 2009. RESULTS: In our study, all patients were having bilateral nasal polypi. Age range was between 26 and 38 years. Frequency of patients having retracted tympanic membrane on right side was 25 (35.7%), and those who developed it on left side was 30 (42.9%). However, 35 (50%) of the 70 patients were having retraction of tympanic membrane whether right or left. This shows frequency of otitis media in patients of nasal polypi was found to be 50%. CONCLUSION: Frequency of developing otitis media in patients of nasal polypi is quite high. Nasal problems lead to development of ear diseases.

Comparative study of inverting sutureline versus over and over continuous suturing in hypospadias repair.

BACKGROUND: Hypospadias is one of the most common congenital anomalies of the male newborns affecting 1 in 300. Urethral meatus lies ectopically on the ventral surface of penis proximal to its normal position. There is defective development of urethral spongiosum and ventral prepuce. Various degrees of chordee may be associated. Objective of the study was to study the incidence of urethrocutaneous fistula formation after hypospadias repair employing two different suturing techniques. This Prospective Randomised Descriptive Clinical Trial was conducted in Department of Surgery, Fauji Foundation Hospital, Rawalpindi and Basharat Hospital, Rawalpindi, during a period of five years from January 2005 till December, 2009. METHODS: A prospective study of 100 patients of glanular/penile hypospadias requiring repair was completed from January, 2005 till December, 2009. Fifty of these patients had urethral tube reconstruction using conventional over and over continuous suturing technique (Group-1). In another group of fifty patients continuous inverting sutures (Connel technique) commonly used in intestinal anastomosis was employed (Group-2). Polyglycolic acid sutures 4/0 to 6/0 as appropriate were used for all the repairs in both the groups by the same surgeon. RESULTS: Six (12%) urethrocutaneous fistulas formed in the Group-1 of fifty patients with over and over continuous suturing as compared to 4 (8%) in Group-II with equal number of patients where inverting suture technique was used. CONCLUSION: Inverting sutures reduce the incidence of urethrocutaneous fistula formation in hypospadias repair.