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

Delayed Migration of Embolized Coil with Large Renal Stone Formation: A Rare Presentation

Delayed bleeding following percutaneous nephrolithotomy (PCNL) usually occurs due to development of the pseudoaneurysm which can be successfully managed with coil embolization. However very few cases of such complications have been reported in the literature. Here we are reporting a case of delayed post-PCNL bleeding that occurred in a 53-year-old diabetic patient operated on for renal stone. Computed tomography scan revealed a presence of the pseudoaneurysm in the segmental branch of right renal artery, which was successfully managed with coiling. Patient remained asymptomatic for the next 9 years after which he again presented with similar complaints. X-ray KUB was done which revealed a 2.7 cms renal pelvic calculus with the migrated coil in its center and a left upper ureteric calculus. His routine haemogram, coagulogram, serum electrolytes, and liver function tests, renal function tests, vitamin D3, and PTH (parathyroid hormone) were within normal limits. He underwent left laparoscopic ureterolithotomy and right percutaneous nephrolithotomy (PCNL). Intraoperatively the migrated stainless steel embolization coil was seen engulfed all around by the multiple stones in the right renal pelvis. Postoperative period was uneventful. Later he was followed in the outpatient department and was doing well. To conclude, this is the only case report of development of a large calculus around a migrated embolization coil which was successfully managed with PCNL. PCNL offers better stone clearance in cases of stones being formed over foreign bodies like fragmented double J stents, fragmented nephrostomies, or migrated embolization coil

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