Unusual Foreign Body in Urinary Bladder: A Case Report

In the urinary tract, foreign body is most commonly found in the urinary bladder. It is commonly self-inflicted but can rarely be introduced by other person. Various types of foreign bodies have been reported, which includes infusion set, aluminum rod, gold chain, pearl, fish, pencil etc. Here we report a case of a 28-year young man who gave the history of forceful introduction of a long wire of mobile charger into the bladder by another person. It could not be removed by himself and by the local doctors. Then he was referred to Enam Medical College & Hospital and subsequently was removed by suprapubic cystostomy

Isolated Metastatic Malignant Melanoma of the Right Inguinal Lymph Node with Unknown Primary Lesion

Malignant melanoma develops from the pigment containing cells known as melanocytes. Melanoma is more common in men than in women. It is found typically in the skin. It is also found in the mouth, intestine, eye and other sites. Melanoma may develop from a mole with changes including an increasing in size, irregular edges, changes in color, itchiness or skin breakdown. Prognosis is poor if it is not treated early. The primary cause of melanoma is UV light exposure. Patients with history of affected family members and poor immune function are at greater risk. Diagnosis is by biopsy from any affected skin lesion. Recurrence is common even many years after the initial diagnosis. Here we present a case of malignant melanoma of the inguinal lymph node with unknown primary lesion. Surgery was done with complete excision of inguinal lymph node. Biopsy report showed metastatic malignant melanoma

Comparative Study between Slow Shock Wave Lithotripsy and Fast Shock Wave Lithotripsy in the Management of Renal Stone

Background: Renal calculi are frequent causes of ureteric colic. Extracorporeal shock wave lithotripsy is the most common treatment of these stones. It uses focused sound waves to break up stones externally. Objective: To compare the efficiency of slow and fast delivery rate of shock waves on stone fragmentation and treatment outcome in patients with renal calculi. Materials and Methods: This prospective study was done in the department of Urology, National Institute of Kidney diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2006 to June 2007. Total 90 patients were treated using the Storz Medical Modulith ® SLX lithotripter. Patients were divided into Group A, Group B and Group C – each group having 30 subjects. Group A was selected for extracorporeal shockwave lithotripsy (ESWL) by 60 shock waves per minute, Group B by 90 shock waves per minute and Group C by 120 shock waves per minute. Results: Complete clearance of stone was observed in 24 patients in Group A and 13 patients in both Group B and Group C in first session. In Group A only 3 patients needed second session but in Group B and Group C, 12 and 8 patients needed second session. In Group A only one patient needed third session but third session was required for 3 patients in Group B and 5 patients in Group C for complete clearance of stone. In Group A, subsequent sessions were performed under spinal anesthesia and in Group B under sedation and analgesia (p>0.001). Mean number of sessions for full clearance of stones in group A was 1.37 ± 0.85, in Group B was 1.8 ± 0.887 and in Group C was 2.0 ± 1.083. Significant difference was observed in term of sessions among groups (p>0.05). In first follow-up, complete clearance of stones was seen in 24 patients in Group A and 13 in both Group B and Group C. In second follow-up, 3 patients in Group A, 12 in Group B and 8 in Group C showed complete clearance of stones. It was observed that rate of stone clearance was higher in Group A than in Group B and Group C. Multiple logistic regression analyses revealed that slow delivery rate (60 SW/min) as well as age (younger), symptom (painful) at onset, stone location (upper and middle calyx) and size (small) were independent prognostic factors determining stone clearance after ESWL of renal stone. Conclusion: Slow rate shock wave delivery improves efficacy of ESWL treatments of renal stone and decreased number of sessions, shock waves and treatment time

Fasciolopsis buski Infection in a 50-Year-Old Female

Fasciolopsiasis is a disease caused by the largest food-borne intestinal trematode known as Fasciolopsis buski. Here we report a case of a 50-year-old female who presented with upper abdominal pain and vomiting for one month. She was previously diagnosed as a case of choledocholithiasis. Endoscopic retrograde cholangio-pancreatography (ERCP) revealed stones along with two leaf-shaped worms which were removed from the duodenum of the patient. The worms were identified as F. buski by its unique morphology. Awareness regarding this parasitic infestation, especially in the rural area, should gain attention while formulating strategies to prevent and manage such infestation