Objective: To determine the role of X-Ray and ultrasonography combined versus intravenous urography in diagnosing cause of renal colic. Study Design: Experimental study. Setting: Urology Department of Margalla Hospital PMO Taxila. Period: July to December 2019. Material & Methods: Cases presenting with renal colic in urology Out-Patient door Department suspecting renal stone, ureteric or PUJ obstruction were included in this study. Patients below 14 years, hypersensitivity to intravenous contrast media and renal failure or having any condition with deranged blood urea and creatinine level were excluded from the study. X-ray, ultrasonography of abdomen, KUB (kidney, ureter and urinary bladder) and intravenous urography was done in every patient included in the study. Results: Sample size was 200. Mean age of patients was 38.4±6.8 years. Right sided renal colic was more common (45%) than left sided (42.5%) and bilateral flank pain (12.5%). On IVU hydronephrosis with obstructing renal stone was found in 45.5% cases, ureteric stone in 40.5% and hydronephrosis with non-obstructing stone was found in 14% cases. On x-ray and ultrasonography KUB, hydronephrosis with obstructing renal stone found in 38.5% cases, ureteric stone in 13.5%, renal stone in 39.5% and hydronephrosis with non-obstructing stone was diagnosed in 6% cases. When results of x-ray ultrasonography compared with IVU, calculi were diagnosed in 53% cases (sensitivity 87% and specificity 100%), hydronephrosis was detected in 98 cases (sensitivity 97%, specificity 95%). Conclusion: X-ray KUB and ultrasonography combined have almost equal accuracy as intravenous urography in diagnosing renal colic.
Objective: To determine frequency of fungal infection of urinary tract in patients with liver cirrhosis Design & duration: This is a cross sectional study. This study was completed in duration of six months. Setting: Study was conducted in Margalla Hospital Gulshan Colony PMO, Taxila. Patients & Methods: Patients admitted in study hospital with liver cirrhosis having child class A, B and C were evaluated for fungal urinary tract infection, belonging to any gender, having age above 40 years. All data was documented and analyzed using SPSS software version-20 and means, frequencies, standard deviation and p-value were calculated. Results presented in the form of tables and graphs. Results: Total 400 cases were evaluated for fungal urinary tract infection having liver cirrhosis admitted in study hospital in given duration of study. Fungal cause of UTI was found in 260 cases including 29.3% male and 70.7% female cases. While other causes were found in 140 cases. According to child classification out of 260 cases with fungal UTI, 11 cases were in class B and 249 cases were in class-C while no case belonged to class-A. Most of the cases (42%) with UTI were in age interval of 40-50 years. Duration of CLD was 2-4 years in most of the cases (30%). Conclusion: Fungal cause of urinary tract infection is very common among patients with liver cirrhosis and older age as these cases have week immunity Key words: Liver cirrhosis, chronic liver disease, urinary tract infection, fungal infection, immunocompromised
Background and Aim:Prostate histological enlargement known as Benign Prostatic Hyperplasia (BPH) is the major challenge for aging men with substantial burden on the health care system. It is associated with incomplete emptying sensations and impedance in flow due to symptoms of the lower urinary tract. Patient of higher body mass index (BMI) or obese have larger prostate volume (PV) and increase in lower urinary tract symptoms (LUTS) compared to normal BMI patient as reported by many researchers. The current study aim was to correlate the association between obesity and prostate volume in BPH patients. Materials and Methods: This cross-sectional was conducted on 140 BPH patients with 45 years to 75 years age range admitted in the department of Urology, DHQ Teaching Hospital, Dera Ismail Khan for six months duration from July 2020 to December 2020. BMI of each individual was calculated using height and weight measurements. Measuring tape was used to measure waist circumference (WC) while Prostate volume (PV) was measured with Transrectal Ultrasound (TRUS). Demographic and clinical parameters such as diabetes, smoking, prostate specific antigen (PSA) and hypertension were recorded on pre-designed proforma. Outcome variables were BMI and prostate volume. Results:Patients were divided into three categories based on BMI namely Obese, overweight and normal. Mean value for age and BMI was 61.34±5.324 and 26.89±4.13 respectively. Mean PV of Obese, overweight and normal BMI were 61.34±7.5, 59±3.10 and 50.91±8.5 cm3 respectively. The PV average score was 58.42±6.53 cm3. The mean value for waist circumference (WC) and PSA were 97.20 and 5.10±3.23 with 1.2-5.9 range respectively. The correlation between PV and BMI as well as between WC and PV, diabetes, smoking and hypertension shown no significance (p value=0.195). However, PSA and PV correlation give significant (p value 0.001-0.009) correlation. Conclusion:Central obesity plays a key role in developing and promoting BPH. The highest prevalence of BPH was found in patients with BMI >30kg/m2 while lowest in men of BMI <23 kg/m2. The current study found higher frequency of BPH among patients with WC >90 cm and lowest in men of WC <90 cm. A positive correlation was found between WC, BMI and PV. Individual quality of life affected by LUTS caused by severe risk of BPH due to increase in obesity. Balance diet and physical exercise help in maintaining the healthier BMI among obese and aged men. Keywords: Benign prostate hypertrophy, Bladder outlet obstruction, Prostate volume
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