Background: Urolithiasis encompasses both renal and ureteric stones. It is estimated that up to 5% of the world population is affected by this disease and the lifetime risk of getting urinary stone is 8-15%. The aim of this study is to look for epidemiological patterns in the disease distribution, understand the causative factors of the disease and assess the existing surgical modalities of treatment of this disease. Subjects and Methods: In the present study 68 cases of Urolithiasis fulfilling the study parameters were admitted and subsequently operated in Medical College and Research Hospital. Results: 65% of the patients were between age group 18-40. The most common site of urinary calculus was lower 1/3ureter followed by lower pole kidney. Diet, fluid intake, diabetes and obesity were significant predisposing factors for urolithiasis. PCNL was the treatment of choice for renal calculus while ECSWL was treatment of choice in upper ureteric calculi and ureteroscopy for lower ureteric calculi. Conclusion: For renal calculi, PCNL is the best treatment modality as of now, but it is associated with greater post-operative morbidity. For stone less than 1cm size, ECSWL is a good alternative to PCNL, but has poor clearance rate and thus greater need for auxiliary procedure. For ureteric calculi, both ECSWL and ureteroscopy have given good results but ECSWL is better tolerated by the patients.
Peripheral Artery Disease (PAD) of the upper extremities is common. It is most often asymptomatic but may cause exertional pains, ischemic pains, gangrene or ulceration. The risk factors for PAD are smoking, obesity, hypertension, diabetes, hypercholesterolemia and end stage renal disease. Here the authors reported a case of 45-year-old male patient, presenting with severe aching type of pain associated with paraesthesia and numbness and blue, cold and gangrenous right forearm which was amputated below the elbow. After amputation, the condition advanced and led to weakness of the right upper arm with bone necrosis and surrounding skin was hyperaemic and oedematous with differential warmth, therefore the patient undergone amputation of the right upper arm and was managed postoperatively with antibiotics and the wound was closed with non absorbable sutures and was on oral anticoagulant therapy and after complete recovery, patient was discharged. On follow-up, removal of sutures was done and patient was referred for physiotherapy for muscle strengthening and prosthesis fitment.
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