Primary signet-ring cell carcinoma of the urinary bladder

Primary signet-ring cell carcinoma of the urinary bladder is a rare tumor. The overall incidence is approximately 0.12-0.6% of all urinary bladder malignancies. The majority of the patients present in an advanced stage with a uniformly grim prognosis. As signet-ring cell carcinomas are more common in the gastrointestinal tract, a possibility of metastasis needs to be considered. Here we report, a 42-year-old patient who presented with hematuria and was diagnosed with a urinary bladder tumor. The patient was managed with partial cystectomy and pelvic lymph node dissection. The histopathological examination confirmed primary signet-ring cell carcinoma of the urinary bladder

Robot-assisted pyeloplasty for pelvi-ureteric junction obstruction of lower moiety in partial duplex system: A technical challenge

Management of pelvi-ureteric junction obstruction (PUJO) in a duplex system is technically challenging as dissection at the pelvis may jeopardize the vascularity of the normal moiety ureter. Anastomosing the pelvis to the one single ureter will have a risk of future development of stricture which then will risk both the moieties. Robotic assistance enables appropriate tissue dissection; minimal handling of normal ureter and precision in suturing, overcoming the potential challenges involved in the minimally invasive management of such complex cases. We report the feasibility and efficacy of robot-assisted laparoscopic pyeloplasty in such case

Malignant Pelvic Pheochromocytoma Presenting as NonFunctioning Kidney and Accelerated Hypertension: A Rare Presentation

Paragangliomas are neuroendocrine tumors that arise from sympathetic nerve ganglia. They can develop anywhere from the neck to the pelvis, but are most commonly found in the abdomen, particularly at the aortic bifurcation or in the periaortic region. Malignant paragangliomas account for 29–40% of cases. We report a case of 36-year hypertensive female presented with and right flank pain and accelerated hypertension. On evaluation she was diagnosed to have non unctioning kidney due to malignant pelvic paraganglioma with right ureteric encasement. We believe our case is one of the first reported in literature as rare presentation of malignant paraganglioma presenting as nonfunctioning kidney and accelerated hypertension

Socio-demographic profile of IUCD acceptors attending PostPartum Unit (P.P.U.) of Guru Govindsingh Hospital, Jamnagar

Background: The family welfare programme is a priority health programme for our country. In spite of integrated and concerted efforts, the programme has not been able to make an appreciable reduction of Crude Birth Rate. This was mainly because it had almost become synonymous with sterilization and majority of the couples had undergone sterilization only after achieving their desired family size of more than three children. So, the program has shifted its focus on spacing methods to reduce CBR. Aims: To assess the socio-demographic profile of women using IUCD and the decision-making status of women in selection of spacing methods. Material and Methods: All IUCD acceptors (Total 413 women) attending postpartum unit of G.G. Hospital, Jamnagar from October 2012 to December 2012 were studied. Results: A total 185 (44.79%) acceptors were in the age group of 24–28 years, 337(81.59%) of acceptors were literate, 238 (57.62%) acceptors had two or more living children. In 370 (89.58%) cases, IUCD was inserted within 10 days of menstruation & only 20 (4.84%) women had got IUCD inserted within 6 weeks of last delivery. Only 28 (6.77%) women took decision themselves for IUCD insertion. Decision making status of women was positively associated with their high education level. Conclusion: Majority of IUCD users were young women, indicating that spacing is being adopted in the early twenties. Majority of the users were literate & their educational level was significantly associated with their decision making status in matters of opting for contraception

A Rare Case of Continuous Type Splenogonadal Fusion in a Young Male with Primary Infertility

Splenogonadal fusion is a rare developmental anomaly in which an abnormal connection between splenic tissue and gonads or mesonephric derivatives is present. Here we present a case of young man with the complaint of primary infertility for 3 years. On evaluation (USG and MRI abdomen and pelvis), his right scrotal testis was atrophied and left intra-abdominal undescended testis. On laparoscopic assessment, a mass was seen on the left side due to continuous type of splenogonadal fusion for which excision and left orchidectomy were done. Postoperative period was uneventful and he was discharged under satisfactory condition. Splenogonadal fusion is a rare entity and it is commonly mistaken for testicular tumour. It should be considered in the differential diagnosis of testicular masses especially when there are associated congenital anomalies and preoperative laparoscopic assessment, should be done to avoid unnecessary radical surgery