Background Renal tumor is the 13th most common malignancy in the world and more than 90% of renal tumors are renal cell carcinomas. As there is no data available on renal cell carcinoma in Nepal, hence this study was undertaken to analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. Objectives To analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. Methods The case records of 50 consecutive patients with renal cell carcinoma presenting at the Tribhuvan University Teaching Hospital, Kathmandu from July 2006 to June 2011 were retrospectively evaluated for presenting symptoms, physical finding, investigation and histopathology report. Results Out of 50 patients, 64% were male and 36% were female. The age ranged between 11 to 78 years (mean ± SD: 55 ± 15 years). Fifty four percent of patients were smokers. Incidentally tumor was detected in 40% cases by ultrasonography and the typical triad was present in only 4%. The tumor was occupying upper pole in 40% of cases. The tumor size ranged from 3 to 15 cm (mean ± SD: 7.3 ± 2.9 cm). Histopathologically, 76% of the patient had organ confined renal cell carcinoma (T1-2 N0 M0). Clear cell was the most common type seen in 86%. Fuhrman’s nuclear grade 2 was found in 50%. ConclusionMany of the renal cell carcinoma are detected incidentally, at an early stage and are of clear cell subtype.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6302 Kathmandu Univ Med J 2011;9(3):185-8

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To evaluate women undergoing emergency peripartum hysterectomy (EPH) during COVID-19 pandemic regarding their sociodemographic features, indications, intraoperative and postoperative complications, and assess their health problems related to a traumatic birth. MethodsThis was a retrospective review of EPH cases operated from March 2020 to March 2021 in terms of demographic characteristics, intraoperative, and postoperative outcome variables. ResultsDuring the specified time period, there were nine cases of EPH. All patients were young with ages ranging from 25 to 31 years; all were unbooked having unplanned pregnancies and presented at varying gestational ages. Six out of nine cases (66.67%) had previously scarred uterus with five women having morbidly adhered placenta. A total of 77.78% (seven out of nine) patients referred to our centre with high-risk factors. Five out of nine women (55.56%) needed ICU care. Seven out of nine women (77.78%) had live births and two of these infants died. The guilt of losing the baby, lethargy, worries related to feminity and sexual health, and flashbacks of ICU stay were major concerns. ConclusionThe morbidly adhered placenta was the primary cause of EPH in our study cohort. Preventive psychological session should be an integral part of postpartum follow-up visits for any women with traumatic childbirth.

Background: Primary vesical stones are common in children in underdeveloped and developing countries. The treatment options available for managing bladder calculi include transurethral cystolithotripsy, open cystolithotomy and shock wave lithotripsy (SWL). Although the majority of vesical calculi in adults can be treated by transurethral lithotripsy, this procedure is restricted in children due to the narrow caliber of the urethra. For this reason, percutaneous cystolithotripsy (PCCL) is a good choice as a safe and effective method for the treatment of bladder stones in children. Aim of the Study: The study was aimed to evaluate outcome of PCCL in pediatric population coming with vesiculolithiasis in our center. Materials and Methods: Pediatric age group patients diagnosed as vesical calculus were undertaken for PCCL. Ten patients who presented between November 2014 to December 2015, were included. The procedure was done under general anesthesia. After performing cystoscopy, suprapubic puncture was made and tract dilated upto 26 Fr. Nephroscope was used for visualization and pneumatic lithotripsy for fragmentation of the stone followed by removal of st nd all fragments. Perurethral and suprapubic catheters were placed at the end to be removed on 1 and 2 post operative day, respectively. Results: Median age of the patients was 5.5 (3-13) years. Majority were male patients from hilly region of western Nepal. Mean stone size was 15 mm. All patients were rendered stone free with average operative time of 32.2 minutes. Except one minor complication of mucosal injury patients were discharged after mean hospital stay of 3.9 days. Conclusion: Percutaneous suprapubic lithotripsy is a safe and effective method for the treatment of bladder stones in children. It is fast and associated with negligible complications.

Background: Benign enlargement of prostate (BEP) needs treatment based on evaluation of symptom scoring among which International prostate symptom score (IPSS) is the standard one but carries difficulty in completion of the form. A visual prostate symptom score (VPSS) can evaluate the symptom with similar efficacy in a larger population with lower education. Aim of the study: The study was aimed to evaluate the correlation of the VPSS with uroflowmetry parameters. Materials and Methods. Men provisionally diagnosed as BEP were requested to complete the IPSS and VPSS, consisting of pictograms to evaluate urinary frequency, nocturia, force of the stream and quality of life. The maximum (Qmax) and average urinary flow rate (Qave), voided volume (VV) and post-void residual (PVR) urine volumes were measured. Statistical analysis was performed using the chi square test and Spearman's tests. Results. The study included 45 men (mean age 66 years, range 50-78 yrs.), with median prostate weight of 40 gm. One fourth of the patients were illiterate. Majority of the patients could complete VPSS without physician's assistance (46%). With mean voided volume of 273 ml, mean Qmax and Qave were 10.8 and 5.7, respectively. There was significant negative correlation of VPSS with Qmax (r=-0.435, p=0.003) and negative correlation of IPSS with Qmax, though insignificant (r=-0