Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard first-line treatment for renal stones. It a successful, less invasive surgery (> 90%) but with high complication rate (> 10%). The study aims to see the outcome of PCNL in patients with renal stone who were treated. Materials and Methods: A retrospective study which included all the cases that presented with renal stone and who underwent PCNL for the treatment. The data included in this study was from April 2019 to December 2021. Ethical clearance was obtained from the institutional Review Committee (F-NMC/578/078-079). The data were collected from the records available in the record section We evaluated the distribution of presentation, puncture site, stone clearance, blood loss, postoperative stenting and complications of the surgery. Results: The total of 63 cases underwent PCNL in our institute. The mean age of the patients was 34.68±14.108 years and mean size of the stone was 5.7531±18.07804 cm3. Among the total cases, 52% cases presented with renal stone on the left kidney, 54% presents in the pelvic ureteric junction. In 71% cases puncture was made in the lower pole and in 63.5% single puncture was made to proceed. Complete clearance of stone was seen in 94% cases, 4.8% developed urosepsis and 6.3% required blood transfusion. Stenting was done postoperatively in 95% cases. Conclusion: The total stone clearance rate in our study was 94% which higher when compared to other study. With the increase in case flow the efficacy of the procedure will increase and along with this the outcome of the procedure will increase.
Introduction: Transurethral resection of the prostate requires a catheter in situ post-surgery. Early removal of catheter can reduce the length of hospital stay reducing the healthcare cost. It can also reduce the risk of infection due to prolonged catheterization. Our aim was to determine the median duration of hospital stay after early foley’s removal after transurethral resection of prostate among patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was done in a tertiary care hospital from July 2019 to December 2020 and ethical clearance was obtained from the institutional review committee. Foley’s catheter were removed on the first post-operative day, who met the criteria of catheter removal. Convenience sampling was done. After foley’s removal patients were observed for spontaneous voiding. Patients with complications like hematuria, clot retention, urinary retention were recatherized. The data were expressed in mean with standard deviation, median with interquartile range and frequency and percentage as applicable using Statistical Package for the Social Sciences version 16. Results: Out of the 150 participants included in the study, the median duration of hospital stay after the early removal of foley's catheter was 3 days (interquartile range 2-4 days). A total of 20 (13.3%) patients underwent recatherization. Nine (6%) patients had to be recatheterized due to clot retention, and 11 (7.3%) were due to urinary retention. Conclusions: This study showed that the median duration of hospital stay after early removal of foley's catheter among patients undergoing transurethral resection of the prostate was similar to studies done in national/international settings.
ABSTRACT Background and objectives: Among many lithotripters for fragmentation of ureteric stones, pneumatic and Holmium: YAG laser lithotripsy has reported favorable outcomes. The aim of this study is to compare the efficacy of pneumatic lithotripsy with laser lithotripsy in ureteral stone. Materials and methods: In this prospective study, 60 patients with diagnosis of ureteral calculus underwent ureteroscopic lithotripsy in Urology Unit, Department Surgery, National Medical College and Teaching Hospital over period of 2020 to 2021. They were divided randomly into two groups, each group with 30 patients. Group PL was treated with Pneumatic lithotripsy and Group LL was treated with Holmium: YAG laser lithotripsy. History and detailed clinical examination was performed as per the working proforma which included. Result of both the procedures was assessed. Chi square test were used for correlation analysis. Data analysis was done using SPSS (Statistical Package for social sciences), version 25. Results: Mean age was 26.5 years and 36.33 years in group PL and LL respectively (P=0.58), there was no significant difference in male to female ratio and mean stone in both groups. Duration of operation was significantly lower in LL group and Hospital was slight lower in LL group as compare to PL group (0.95). Conclusion: Ho:YAG laser and pneumatic lithotripsy are efficient and safe procedures for ureteral stones. Though operative time is higher in pneumatic lithotripsy.
Introduction: Laparoscopic cholecystectomy is clean-contaminated surgery. Prophylactic antibiotics are used to reduce SSI but there is still controversy regarding use of antibiotics in postoperative period. The aim of this study is to compare the effect of single dose versus multiple doses of antibiotics in terms of wound infection. Methods: This prospective study was carried out in department of surgery of National Medical College and Teaching Hospital, Birgunj from March 2020 to March 2021. Patients with diagnosis of symptomatic cholelithiasis were divided alternatively in single dose (SD) group and multiple doses (MD) group. SD group were given injection ceftriaxone 1gm at the time of induction of anaesthesia and MD group received injection ceftriaxone 1gm at the time induction of anaesthesia and followed by continuation of same dose twice a day for 2 days. Results: A total of 249 patients were enrolled in the study. Among 249 patients, 127 patients were in the single dose (SD) group and 122 patients in (MD) group. The mean age of patient was 37.37±14.30 years with minimum age of 13 years and maximum 75 years. In single dose (SD) group, 5(3.9%) patients developed wound infection and 3(2.5%) patients in multiple (MD) group developed wound infection which was not statistically significant (p=0.437) Conclusion: Single dose antibiotic was found as effective as multiple doses of antibiotics in terms of wound infection in laparoscopic cholecystectomy.
INTRODUCTIONCholelithiasis is a common presentation in the department of surgery. One of the potential risk factors of cholelithiasis is obesity, which is a common problem faced by most adult population. The aim of this study is to see the association of cholelithiasis with body mass index among different age groups. MATERIAL AND METHODSThis cross-sectional study was done in the Department of General Surgery of National Medical College, Birgunj. Ethical clearance (Ref. F-NMC/565/078-079) was obtained from the institutional review committee. Total of 75 subjects were included in the study. Subjects presenting with cholelithiasis in the out-patient department of Surgery were included in the study. Height and weight of the subjects were recorded along with age and other parameters. Body mass index (BMI) was calculated using the Quetelet’s formula, weight in kg/ height in m2. The body mass index was than categorized according to World Health Organization. RESULTSThe mean age of the total participants was 43.85±11.82 years. The mean BMI was 25.81±9.95 kg/m2. Among the age group 20 – 35 years 30% were overweight and 15% were obese where as in age group 36 – 50 years 44.4 % were overweight and 11.2 % were obese. Similarly in participants above 50 years 32.1% were overweight and only 3.6% were obese. CONCLUSIONCholelithiasis is one of the common surgical problems. Number of patients with gallstones increases with increasing age. In this study, more number patients are seen with normal BMI. However, higher number of patients are found having overweight or obesity in the age group of 36-50 years.
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