Study of Virtual Memory

This research report gives a general description of virtual memory systems. The mechanisms and policies and their effect on the operation and efficiency of virtual memory are explained. A virtual memory using a real time virtual address decoder, to decode a 32 bits of virtual address for the secondary memory to obtain the primary address location discussed. The decoder is developed with the use of associative or content-addressable memories. Replacement algorithms, used for selecting the pages of the main memory to be replaced, are described. The hardware implementation of the least recently used and least often used replacement policies using associative memories is presented

Augmentation gastrocystoplasty in a child with orofacial syndrome and dysfunctional voiding

We report the case of a child diagnosed with orofacial syndrome with dysfunctional voiding and elevated serum creatinine in whom augmentation gastrocystoplasty was performed to manage urinary incontinence.Keywords: augmentation gastrocystoplasty, dysfunctional voiding, orofacial syndrom

An unusual presentation of anterior urethral valve in a child with diabetes mellitus

Anterior urethral valve (AUV) is identified to be a common source of congenital obstructive lesion of the anterior urethra. Up to 80% of children with AUVs develop bladder dysfunction, bladder instability, hyperreflexia, diminished compliance and capacity. We report a case of an unusual presentation of a child with AUV and diabetes mellitus

Management of antenatally diagnosed hydronephrosis in a child presenting later with urinary tract infections: A case report

Preservation of renal function remains the main goal of follow-up of a child with antenatal hydronephrosis. The question remains as to how long we need to follow these children. Even after several decades, the indications and timing of surgery in a newborn with hydronephrosis are still debated. Herewith, we report the case of a 9-year-old male child who was diagnosed to have hydronephrosis on antenatal scans and was managed conservatively postnatally who presented after 9 years with recurrent urinary tract infections

Synchronous bilateral wilms' tumor in a 2-year-old male child

Wilms' tumor (WT) is the most common malignant renal tumor in childhood. Approximately 5%–7% of WT patients present with bilateral disease, either synchronously or metachronously. Bilateral WT usually occurs in younger children and more often in girls. Management of a child with bilateral WT is very challenging. We report a case of bilateral WT in a 2-year-old male child. The child has undergone preoperative chemotherapy followed by nephron-sparing surgery

Renal transplant in a child with Alport syndrome

Alport syndrome is a rare inheritable renal disease characterized by renal, cochlear, and ocular involvement. Patients commonly require renal replacement therapy in the second or third decade of life. Renal transplantation in pediatric patients has become a routinely successful procedure, with 1- and 5-year patient survival rates of 98%, the range takes into account the differences between living and deceased donors. These good outcomes represent the cumulative effect of improvements in pre- and post-transplant patient care, operative techniques, immunosuppression, and infection prophylaxis, diagnosis, and treatment. We report the case of a male child with Alport syndrome who underwent preemptive live renal transplant and his mother was the donor

Supine percutaneous nephrolithotomy in children

Introduction: The stone disease in children shows wide geographic variations, and its incidence has increased worldwide in children of all ages. Percutaneous nephrolithotomy (PCNL) has gradually emerged as one of the standard treatment options for the management of renal stones >1.5 cm in pediatric cases. PCNL just like in adults has been performed in the prone position. Of late observing the successful use of supine position for PCNL in adults, pediatric urologists have been encouraged to use the supine access for PCNL in children. We report our early experience with supine PCNL in children. Materials and Methods: All children with symptomatic renal stones presenting to the pediatric urological services of our hospital were prospectively included into the study to undergo supine PCNL. Children with skeletal anomalies, bleeding diathesis, and active urinary tract infection were excluded from the study. Results: Ten children (six males and four females) with a mean age of 11.48 ± 2.08 years (9–18 years) underwent supine PCNL. The mean size of the stone was 22 mm (range 17–47 mm). The initial stone-free rate was 90% immediately after a single PCNL session. One child needed an additional extracorporeal shockwave lithotripsy session to clear a 7-mm fragment. The average operative time (from the beginning of the puncture trial to nephrostomy tube insertion) was 70 ± 5 min. Conclusions: Supine PCNL in children is feasible, safe, and an effective means for management of renal stones in the pediatric population

Anogenital distance in males attending assisted reproduction center

Introduction: Anogenital distance (AGD) is a marker for endocrine disruption in animal studies in which decreased distance has been associated with testicular dysfunction. Measurement of AGD has also been used as a marker for genital development. Recently, it has been used to correlate with sperm production. In this study, we have investigated the relationship between AGD, sperm parameters, testicular size, and total testosterone levels in men attending assisted reproduction center (ARC). Materials and Methods: All the male partners of infertile couples presenting to the ARC were prospectively included in the study. Semen analysis, serum and blood biochemistry tests, and hormone assessment were done in all patients. The AGD measurements were done with the patient lying in supine position, and the distance from the posterior aspect of the scrotum to the anal verge was measured using a digital caliper. Results: The mean AGD was 3.19 ± 0.18 cm in patients with azoospermia, 3.40 ± 0.28 in oligospermia, 3.38 ± 0.24 in oligoasthenospermia, 3.30 ± 0.21 in oligoasthenoteratospermia, and 4.21 ± 0.23 in patients with normal sperm parameters. The testicular volume was significantly lower in patients with abnormal sperm parameters when compared to patients with normal sperm parameters. The total testosterone levels were significantly lower in patients with abnormal sperm parameters when compared to patients with normal sperm parameters. Conclusions: AGD may provide a novel metric to assess testicular function in men. A longer AGD is associated with fatherhood and may predict normal male reproductive potential

Recurrent vesicovaginal fistula: Our experience

INTRODUCTION: One of the major complications of vesicovaginal fistula (VVF) surgery is recurrent fistula formation. A repeat repair is undertaken after resolution of the inflammatory response to the initial procedure. We report our experience with recurrent VVF managed at our center. MATERIALS AND METHODS: We retrospectively reviewed the inpatient/outpatient case records of all women who underwent repair of recurrent VVF at our center. The age of the patient at initial presentation of VVF, cause of VVF, and site, size, position, and type of repair were noted. RESULTS: During the study period from January 2000 to December 2016, a total of nine women with a mean age of 38 years underwent repair for a recurrent VVF at our center. All patients were assessed in detail 12 months after the repair. All patients were continent and were voiding well. CONCLUSIONS: It is important to strictly adhere to the basic surgical principles so as to achieve a successful VVF repair. The bladder closure is much more important in achieving a successful repair than vaginal closure. Recurrent VVFs should always be treated with interposition of a tissue graft between the bladder and the vagina