Introduction: Helicobacter pylori (H. Pylori) as a primary etiological factor in carcinoma stomach. Associationof H. Pylori in gastric cancer has been documented to be in more than 50% of cases. In underdevelopedcountries, this association is shown to be much higher according to different studies.Methods: A prospective observational study of 40 consecutive cases of carcinoma stomach was under takenin surgical department of Shree Birendra hospital and Bir hospital, for a period of two years 2009 to 2011.Location and pathological types of the lesion were noted and all specimens were investigated to see presenceof helicobacter pylori by rapid urease test (RUT) and histological examination.Results: Out of 40 patients, helicobacter pylori positivity was seen in 27 (67.5%) cases by both rapid ureasetest and Histopathological examination (HPE). Regarding the pathological types, out of 26 intestinal type of castomach, 20 (76.92%) cases were positive for H. pylori infection, whereas out of 14 diffuse type of ca stomach,7(50%) cases were positive for H. pylori. In 29 cases of distal ca stomach, H. pylori positivity was seen in 22(75.86%) cases, whereas in rest of the 11 cases the lesion involved other part of the stomach, H. pylori positivitywas seen in 5(45.45%) cases.Conclusion: Helicobacter pylori infection is higher in prevalence in cases of stomach cancer. Its associationwith intestinal histological type of stomach cancer is more common than diffuse type. There is higher prevalenceof Helicobacter pylori infection in distal carcinoma. doi: http://dx.doi.org/10.3126/mjsbh.v12i2.12927

Introductions: Since 1980, when Chaussy in West Germany first demonstrated the efficacy of Dornier prototype lithotripsy HM1, extra corporeal shock wave lithotripsy has become a convenient, noninvasive, outpatient procedure used to fragment urinary stones. It is a standard internationally accepted first line preferred option for the management of renal stone less than 2.5 cm size. Methods: A cross sectional study was conducted in the department of surgery of Shree Birendra Hospital on outpatient department basis during the period of March 2002 to February 2012. All consecutive patients presenting with renal and upper ureteric stones detected either on X-ray or ultrasound of the Kidney- Ureter-Bladder who were treated with extra corporeal shock wave lithotripsy. Descriptive analysis included age, sex, stone location, need of total session, use of double J stent and complications. Results: Total 710 diagnosed cases of urolithiasis were taken for the study. The youngest age was 16 years and oldest 69 years of age. Overall stone clearance rate was 73.52%. The stone free rate for upper, middle, and lower calyx were 85.94%, 90.20% and 50.52% respectively. Conclusions: Extracorporeal shock wave lithotripsy was successful in the management of the stones smaller than 2.5 cm in all caliceal locations and minimal morbidity.Plain Language Summary ESWL with new generation Lithotripter was safe and effective in adult out patients with urolithiasis less than 2.5 cm in functioning kidney without distal obstruction or urine infection. Stone clearance was 70%. DJ stenting was done in stone larger than 2 cm. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13007 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):4-7

Introductions: Ureteral stones account for 20% urinary stone. Two third of ureteral stones are seen in lower third of ureter. Medical expulsive therapy is effective for such stones. This study was designed to observe the efficacy of ‘tamsulosin’ a selective alpha-1 adrenoreceptor antagonist in the management of lower ureteric stone.Methods: A cross sectional study of 70 cases of distal ureteral stones of sizes 5 to 10 mm was taken in the Department of Surgery of Shree Birendra Hospital, Nepalese Army Institute of Health Sciences (NAIHS) from January 2011 to 2013. Patients were randomly divided into tamsulosin and analgesic only groups. Stone expulsion at the end of three weeks was confirmed by X-ray or Ultrasonography.Results: Out of 70 patients, stone clearance rate in tamsulosin group was 28 in 35 cases (80%) and 21 in 35 cases (60%) in group II with analgesic only. The mean time of stone expulsion was 8.3 days in group I and 13.5 days in group II.Conclusions: In this study the use of tamsulosin in treatment of lower ureteral stones less than 10 mm was safe and effective.

Introductions: Laparoscopic surgery is a rapidly emerging option in urology. With the advances in technology and instruments, currently this is viable alternative to treat complex surgical diseases as well as reconstructive surgery.Methods: This was a prospective observational study to analyze the outcome of laparoscopic nephrectomy. A total of 51 patients had undergone laparoscopic nephrectomy over the period of five years. The variables analyzed were, age, sex, operative time, estimated blood loss, length of hospital stay, conversion rate and complication.Results: The patients’ mean age was 41.1 years (range 15-71 years). Indications for nephrectomy were non-functional kidney secondary to stone disease in 26 (50.98%). Mean operative time was 1.43 hours. Median hospital stay was 2.3 days.Conclusions: Laparoscopic surgery is a safe and feasible treatment option for benign renal diseases with comparable outcomes. Non- functional kidney secondary to renal stone was the major cause of nephrectomy in this study. Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):19-22

Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, bleeding, urine leak and infectious complications are major concerns for urologist.  Urologist chooses best technique from list of armamentarium available. Minimally invasive approach like Percutaneous Nephrolithotomy (PCNL) has significantly influenced the renal stone management since 1976. Miniaturisation of the instruments allow more effective and safer alternatives for urolithasis management. Methods: This is a retrospective study in which the outcome of mini PCNL (mPCNL) was compared with standard PCNL (sPCNL) in management of nephrolithiasis. Result: There were no significant difference in stone free rate between mPCNL and sPCNL (96.2 ± 3.6% vs 95.3 ± 4.8%). The total operative time was longer in mPCNL (55.2 ± 19.0 minute vs 62 ± 21.0 minute) but the difference was not statistically significant. Conclusions: Mini PCNL is as effective as standard PCNL with fewer bleeding complications in management of medium sized nephrolithiasis.

Introduction: Double J stent is one common armamentarium used in urological procedure. It can serve both therapeutic and prophylactic function. However the use of double J stent is invariably associated with minor to some of major complications. Forgotten DJ stent is one untoward issue of stenting patient that is largely preventable and entails complex urological procedure to remove it. Methods: We performed descriptive study where data were collected prospectively from patients who have double J ureteral stent in situ after urological procedure. Stent left more than three months was defined as forgotten DJ stent. Demographic characteristics, clinic-radiological data and details of management were noted to evaluate the mode of presentation, associated complications and mode of treatment. The reason behind forgetting those stent was asked with study population and presented.Results: The total of 27 cases of forgotten DJ stent cases were recorded during period of December 2013 to January 2018. Mean age of patient was 46.6 ± 12.25 years. The longest indwelling time was 10 years. Stent syndrome was common mode of presentation followed by encrustation. Majority (92.5%) of the patients were managed with endourological approach and 26% (7) of cases required more than one modalities of treatment.Conclusions: The forgotten stent is an avoidable condition through proper patient counselling. When required the management necessitates simple cystoscopic to complex endourolgical intervention.

A Retrospective Study of Management of Congenital Hydronephrosis, is Early Detection Necessary?

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