Introduction: Honey exhibits a variety of bacteriostatic and bactericidal factors. Due to its variety of antimicrobial and wound healing properties, honey is an effective remedy in wound infections even caused by microorganisms resistant to antibiotics. Nevertheless, there are many known benefits of normal saline soaked gauze dressing as well such as its osmotic properties, cost-effectiveness, and easy availability with no side effects. It is believed that honey as well as normal saline could be used in the management of infected and non-healing wounds and ulcers, pressure wounds, burns, boils, pilonidal sinuses, diabetic and venous ulcers and even malignant wounds with respect to wound size and cleanliness. Purpose of Study: The purpose of this study is to compare the effect of topical honey versus normal saline soaked dressing application in the management of cosmetically improved postoperative infected wounds in pediatric urology patients. Material and Methods: This Randomized Controlled trial was conducted at the Institute of Kidney Diseases (IKD), Hayat Abad Medical Complex (HMC), Peshawar commencing from January 2019 till December 2019 i.e., over a period of one year. Pediatric patients with postoperative wound infections with positive wound cultures were included in the study. The patients were divided into two groups. In group A normal saline soaked dressing was applied and in group B honey was applied three times a day each. Results: A sample size of 60 patients was taken with males 35(58.3%) and females 25(41.7%). Mean age was 5 years with standard deviation of 2.15 with minimum age 1 year and maximum age 10 years. The bacteria on wound culture came out to be Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli in descending order. Patients were divided into two groups. Group A included 30 patients with normal saline soaked dressing application to the wound while Group B included 30 patients with honey application to the infected wound. Both groups were compared in terms of scar improvement and results were found statistically significant 0.028 in group B (Honey). Conclusion: Honey can be used safely and effectively for the management of postoperative surgical site infections in pediatric urology patients as compared to normal saline soaked dressings. Keywords: Honey, postoperative infected wound, pediatric patients

Background: Urinary tract infections are the most frequently reported infections that drive the use of antibiotics around the world. UTI is the 4th most common healthcare-associated infection. Multidrug-resistant (MDR) organisms are predominantly bacteria that are resistant to one or more classes of antimicrobials. The increasing rise in the incidence of MDR-UTI has resulted in increased morbidity, mortality, and treatment cost of the patients. Thus, it is important to highlight the magnitude of the problem, identify the risk factors that result in MDR-UTI, and to take appropriate measures to control its occurrence. Objective: To determine the magnitude of the multidrug-resistant bacteria, their antibiotic-resistant profile, andtheir effect on the treatment cost of the patients Methods: It is a descriptive study conducted in the Department of Urology at the Institute of Kidney Diseases (IKD) from Jan 2019 till 30th March 2020. A total of 54 patients with multi-drug resistant UTI were included in the study irrespective of age and gender. All the data was recorded on a structured pro-forma and was analyzed on SPSS. Results: A total of 3190 patients were operated on from Jan 2019 till 30th March 2020. Out of which 54 patients (1.6 %) developed MDR-UTI. Among them,38 were male and 16 females. The mean age of the patients was 41 ± 18.4. Urolithiasis with infections was found most frequent, in 32 (59.3%) patients. All patients were on broad-spectrum oral antibiotics and had a history of urethral catheterization before the development of MDR-UTI. The most common procedure was Emergency cystoscopy and DJ stent 15 (27.8%). Followed by Percutaneous nephrostomy in 8 (14.8%). Regarding co-morbidities, 38(68.5%) patients had none, 3 patients had diabetes and 6 patients were having Diabetes and Hypertension. Pseudomonas aeruginosa was found most frequent microorganisms in 34 (63%) patients while E.coli in 10 (18.5%) and Klebsiella in 5 (9.3%) patients. Colistin was found sensitive in 36 patients (66.7%). The mean hospital stay in MDR-UTI is 9.28± 5.17 days as compared to 2.1 days in routine cases. Approximately a 4-fold increase was observed in medicines alone in the management of MDR UTI. We recorded 1 mortality (1.9%), case of MDR urosepsis. Linear regression revealed previous use of antibiotics; catheterization, old age, and endo-urological procedures in an emergency as independent risk factors for MDR-UTI. Conclusion: MDR-uti is an emerging local problem. pseudomonas aeruginosa is the most frequently found microorganism in the present setup. it is associated with significant morbidity and very high treatment cost. Keywords: Urinary Tract Infection, Multidrug Resistance, Micro-Organism, Urology, Antimicrobials

Objective: To determine the frequency of successful outcomes of urethroplasty in the management of urethral stricture Methods: It is a descriptive study, conducted in the department of Urology at the Institute of Kidney diseases Peshawar from April 2016 to December 2019. A total number of 85 patients for urethroplasty were included in the study by non-probability convenient sampling. The entire pre-operative, per-operative, and postoperative data were collected on structured proforma and analyzed on SPSS®, version 20.0. Results: The mean age of the patient in this study was 41 years. Regarding etiology, External trauma was the major cause in the form of road traffic accidents in 38.82% while straddle urethral injury in 29.41% of patients, other less frequent causes included iatrogenic urethral trauma and infective stricture. The bulbar urethral stricture was found in 55.29% of cases, with proximal penile and bulboperineal accounting for 23.52% and 21.17% respectively. Significant past surgical history found was suprapubic catheterization in 100%, a failed primary attempt of internal optical urethrotomy (IOU) in 29.41%, multiple recurrences in 48.23%, and re-do urethroplasty in 10.58% of cases. The most common procedure performed was end-to-end anastomotic urethroplasty in 81%, other procedures included penile flap urethroplasty, pull-through procedure, and 10.58% of cases required pubectomy. Urethroplasty was found highly successful in 94% of mean follow-ups 15 months. The cause of failure was wound infection in 1, UTI in 2, and necrosis of penile skin flap in 2 patients. Conclusion: Our initial results conclude that anastomotic urethroplasty is an effective and mainstay treatment modality in the management of urethral stricture disease. It bears less rate of recurrence of urethral stricture. Keywords: Urethroplasty, urethro stricture, Recurrence

Introduction: Benign prostatic hyperplasia (BPH) is a common disease in ageing men and prostate resection is common surgical procedure for it. The symptoms of the enlarge prostate can be assessed by using International Prostate Symptoms Score (IPSS). Some studies show that the resected volume of prostate correlates with the prostate symptoms while some show no correlation between symptoms and volume resected. Objective: To find the correlation between resected volume of prostate and IPSS after resection. Study Design: Cross-Sectional Study. Study Setting: Department of Urology, Institute of Kidney Diseases, Peshawar, Pakistan. Study Duration: 01-10-2020 to 30-03-2022. Material and Methods: Pre-operatively, weight and height were measured by digital weight machine and inches tap. Patients symptoms assesses with IPSS for mild, moderate and severe symptoms. Prostate tissue resected during surgery was put in a 60cc syringe and sent to pathologist for exact volume. Post-operatively, patients were followed after one month for symptoms. The difference between pre and post-operative IPSS was calculated. Results: Mean age, prostate volume and change in IPSS were 57.89±14.18 years, 41.05±6.28 ml and 14.84±3.20. There were 34.1% patients each in 30-49 and 50-59 years age groups and 31.8% in 70-80 years group. Pre-operatively, 68.2% patients presented with severe symptoms, 22.7% with moderate symptoms and 9.1% with mild symptoms. Post-operatively, severe symptoms were reduced to 11.4% while moderate symptoms were seen in 52.3% patients. Mean prostate resected was 41.05 grams. Correlation of change in IPSS and prostate volume was 0.280. Conclusion: There was positive correlation between change in prostate volume and IPSS but it was very weak. In other words, the strength of association between these two is very low i.e. r = 0.280 or 7.8% (0.2802) and not statistically significant i.e. P = 0.065. Keywords: Benign prostatic hyperplasia, enlarge prostate, BHP, IPSS, TURP.

Objective: In patients with kidney stones larger than 2 cm, it is intended to evaluate the effectiveness and safety of small percutaneous nephrolithotomy (mini-PCNL) with conventional percutaneous nephrolithotomy (standard-PCNL). Study Design: Retrospective study Place and Duration: Institute of Kidney Diseases, Hayat Abad Medical Complex, Peshawar, 1st July 2019 - 30th June 2021. Methods: Therewere 170 patients of both genders were presented. All the presented patients had renal stones >2cm were admitted for surgery. Detailed demographics of enrolled cases included age,sex, BMI and comorbidities were recorded after taking informed written consent.Patients were equally divided in two groups. Group I received mini percutaneous nephrolithotomy (mini-PCNL) among 85 patients had renal stone size 2-3cm and 85 patients of group II had renal stone >3cm received standard percutaneous nephrolithotomy (standard-PCNL). Post-operative outcomes among both groups were assessed in terms of Stone-free rate (SFR). SPSS 23.0 was used to analyze all data. Results:Among 170 included cases, 114 (67.1%) patients were males and 56 (32.9%) cases were females. We found that 45 (26.5%) patients had age 20-30 years, 50 (29.4%) patients had age 31-40 years and 75 (44.1%) patients had age >40years. Majority of the patients 130 (76.5%) had BMI <25kg/m2 and 40 (23.5%) had BMI >25kg/m2. Comorbidities were hypertension and diabetes mellitus. We found that operative time of group II was lower 40.7±10.9 minutesas compared to group I 52.4±8.13 minutes while hospitalization, blood transfusion and hemoglobin drops were lower in group I as compared to group II. We found that SFR was higher in group I among 80 (94.1%) cases as compared to group II 78 (91.8%) but difference was insignificant. Most common complications were fever, hematuria and urosepsis but their frequency was higher in group I. Conclusion: Mini-PCNL was an efficient and trustworthy substitute for standard-PCNL in the treatment of renal stones larger than 2 cm (30F). Although there is less blood loss, a lower transfusion rate, and a shorter hospital stay than with standard-PCNL, it nevertheless achieves a similar SFR. The 24F standard-PCNL clearly outperforms the mini-PCNL, but not by much. This method, however, requires more time to complete.