Congenital distal ureteric stricture presenting as obstructive megaureter in an infant: a case report

Congenital distal ureteric stricture is a rare but most important cause of hydro ureteronephrosis in infants presenting as obstructive megaureter. A 8 months old child suffering from recurrent episodes of fever and poor growth had giant hydroureteronephrosis due to distal ureteric stricture. Often misdiagnosed as primary megaureter or pelviureteric junction obstruction, congenital ureteral strictures and valves are the main causes of congenital ureteric obstruction. He was treated with excision of narrow ureteric segment with tapering ureteroplasty and a ureteral reimplantation was performed. This case is presented and discussed with reference to etiology of this rather rare anomaly

Laparoscopic repair of traumatic intraperitoneal bladder rupture: a rare case report

Laparoscopic repair of traumatic intraperitoneal bladder rupture is safe and effective technique. We here report case of 49 year male with traumatic intraperitoneal bladder rupture proven by CT urogram after sustaining blunt trauma abdomen injury, repaired by laparoscopy technique. Patient recovered without any complications and was discharged on postoperative day 6 under stable condition. we here by conclude that if bladder injury identified early and conditions if feasible, laparoscopic repair is one of the good options for further management without involving open laparotomy

Prevalence of dry eye and tear film changes in diabetic population: experience at our tertiary care centre

Background: Abnormalities in tear secretion, alteration of epithelial barrier and autonomic neuropathy lead to tear film and ocular surface changes in diabetes, thus causing dry eye. Aim was the evaluation of tear film and ocular surface of diabetic patients and to assess the prevalence of dry eye in diabetic patients presenting to our department. Methods: It was prospective, observational study. Visual acuity was tested for all the patients and slit lamp evaluation was done followed by staining methods to evaluate dry eye. The parameters included ocular symptoms, Schirmer test, tear meniscus height, tear film breakup time, corneal staining with fluorescein, conjunctival staining, presence of strands/filaments and presence of diabetic retinopathy. Results: A total of 200 diabetic patients were assessed. Forty percent had the duration of diabetes mellitus ranging between 6-10 years. Majority of patients were having grittiness (54%). Around 32% of the study participants are having dry eye. On Schirmer test majority (43%) were having 6-10 mm. 69% of the study participants were having more than 1 mm of tear meniscus height. Majority (69%) of the study participants had more than 10 sec tear film breakup time. 18% of the study participants were having positive conjunctival staining and 18% of the study participants were having positive corneal staining. 13% of the study participants are having filaments/strands. Conclusions: The incidence of dry eye was seen to increase with increasing duration of diabetes and increasing age. Careful elicitation of history followed by proper evaluation to diagnose dry eye is emphasized

Single puncture percutaneous nephrolithotomy for large staghorn calculus: experience at a tertiary care center

Percutaneous nephrolithotomy (PCNL) is recommended procedure for stones greater than 2 cm This procedure is being used commonly by all urologists worldwide. With increasing using of imaging studies, the incidence of large staghorn calculus has been consistently decreasing because most of the stones are being detected while they are still small. In this case report we are presenting a case of a large staghorn calculus of size 6.7×5.2 cm which was completely cleared by PCNL with a need for relook procedure

PREDICTORS OF EARLY AND DELAYED GRAFT FUNCTION IN LIVE AND CADAVERIC RENAL TRANSPLANTATION

Background: Kidney transplantation gives the best quality of life to chronic kidney disease patients and also increases longevity. Aim: Analysis of factors responsible for the early and delayed graft functioning in live and cadaver renal transplants Methods: It was a retrospective observational study. Donor and recipient age, sex, BMI, comorbid illness, and functioning status of the donor kidney, duration and severity of chronic kidney disease and associated bladder disorders were collected. Operative factors like perfusion time, cold ischemia time, blood pressure fall, need for blood transfusion, vasopressor support was recorded. Patients were divided into two groups based on early versus delayed graft function. Results: 27 cases of Live donor renal transplant and 23 cadaver transplants were included. The average age in live donor and cadaveric transplants was 43.5 ±7.6 years and 38.3 ±10.5 years, respectively. 24 Live Transplant Recipients had Early Graft function (89%). Seven Cadaveric Transplant Recipients had Early Graft function (31%) and 16 of them had Delayed Graft Function (69%). HLA Mismatch, Perioperative Hypotension and BMI of recipient had statistically significant relationship to Early Graft Function with p values of 0.02, 0.004 and 0.007, respectively. With p-value of 0.021 and of 0.046, respectively, perioperative hypotension and cold ischemic time in Cadaveric renal transplantation had statistically significant relationship to Early Graft Function. Conclusion: Live donor transplants have better early graft function. HLA Mismatch, Perioperative Hypotension, BMI of recipient and cold ischemic time in Cadaveric renal transplantation are the predictors of early graft function. Keywords Cadaveric,, ,،,؛Kidney transplantation,, ,،,