ABSTRACT… Background: Testicular tumor primarily originate from germ cells and are found in all age groups. Among germ cell tumors one is pure yolk cell tumor which is tumor of infant and pediatric age group and is extremely rare in adulthood. Case Presentation: Current titled case report is about a 23 year old male who presented with painless enlargement of right testis. Examination revealed as hard lump involving right testis and clinically epididymis spared. Hormonal assessment consistent with malignant lesion of testis. Right inguinal approached orchidectomy done and histopathology revealed it as pure yolk sac tumor of testis. Conclusion: Pure yolk cell tumor in adulthood is a very rare tumor and once diagnosed, need follow up in post-operative circumstances. Key words:Testicular Tumor, Germ cell Tumor, Pure Yolk Cell Tumor.
Lower Urinary Tract Symptoms. Alpha-1 adrenoceptor antagonists are most frequently prescribed medical management for LUTS and among these tamsulosin and terazosin are the most common. Objectives: To access comparison of efficacy of tamsulosin and terazosin for management of LUTS due to prostatic hyperplasia in terms of International Prostate Symptom Score (IPSS). Place and duration: Study being conducted at Department of Urology and Kidney Transplantation, Allied Hospital, Faisalabad for period of 24 months from 01-07-2014 to 30-06-2016. Methodology: 659 male patients enrolled in study and randomly assigned to Group A (Patients being administered with tamsulosin) and Group B (Patients being administered with terazosin) and improvement in IPSS monitored over period of two weeks. Results: 659 patients enrolled with mean age+sd as 61.9+10.2 years. Group A includes 330 patients while Group B include 329 patients. Among Group A, 250 patients showed significant improvement in IPSS while in Group B, 215 patients showed significant response to medical management in terms of IPSS and both groups showed statistically comparative response. Statistical response of management also determined in terms of variables of IPSS severity, prostatic size and age of patient and found that efficacy of the two groups were statistically comparable for patients with mild IPSS while in patients with moderate IPSS has response to treatment with tamsulosin but no statistical association of efficacy for treatment with terazosin. No statistical response was found for improvement in symptoms in cases with severe IPSS in either groups. When response monitored in terms of prostate size in both groups, it was found that both groups have statistical response when prostate size is less than 35 grams, between 35-55 grams but in case when prostate size was more than 55 grams, no statistical response was found with group B patients. When response was measured in terms of variable of age, results were consistent with the fact that statistically significant response of efficacy was found in either groups for age group 45-55 years and 56-65 years but no statistical response was found for Group B when considered for age group more than 65 years. Conclusion: Based on results it is concluded that both tamsulosin and terazosin has got comparative results in overall response. However, tamsulosin has superiority in treatment when IPSS is moderate, prostate size is more than 55 grams and age of patient is more than 65 years. Key words:Lower Urinary Tract Symptoms (LUTS), Prostatic Hyperplasia, Alpha-1 Adrenoceptor Antagonists, Tamsulosin, Terazosin.
Objective: To determine the stone free rate by PCNL in pediatric population. Study Design: Descriptive Study. Setting: Department of Urology & Kidney Transplantation, Faisalabad Medical University and Affiliated Hospitals. Period: July 2019 to December 2019. Material & Methods: Total 55 patients were enrolled. After history, examination, relevant pre-operative investigations and informed consent, the patients underwent standard prone PCNL, with ureteral catheter placement, system puncture under fluoroscopic/ultrasound guide, tract dilatation, nephroscopic stone manipulation and retrieval. Pre and post operative images were compared for determinations stone clearance. Other relevant data operative time, need of blood transfusion & complications were recorded. All the information was documented on a proforma. Results: In our study, of 55 cases, 87.27% (n=48) were between 2-10 years of age whereas 12.73% (n=7) were between 11-14 years of age, mean+sd was calculated as 8.44+2.31 years. 56.36% (n=31) were male and 43.64% (n=24) were female. Frequency of stone clearance was recorded in 80% (n=44) whereas 20% (n=11) didn’t stone clearance. Conclusion: Frequency of stone clearance is high with percutaneous nephrolithotomy (PCNL) in pediatric population.
Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.
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