Increasing resistance among urinary tract pathogens to conventional drugs is found alarming worldwide. The aim of this study was to obtain data on susceptibility patterns of isolated uropathogens from urine samples of patients attending at Khwaja Yunus Ali Medical College Hospital, Enayetpur, Sirajgonj, Bangladesh a tertiary health care center of remote area to currently used antimicrobial agents. A total of 656 urine samples were studied of which 163 (24.8%) were culture positive. Among 163 culture positive cases all uropathogenic isolates were identified. Among the isolates, E. coli was the most predominant 116 (71.1%) followed by Pseudomonas aeruginosa 29 (17.8%). Staphylococcus saprophyticus 12 (7.4%) and Klebsiella pneumoniae 4 (2.4%) and Acenatobacter sp. 2 (1.2%). The majority of isolated E. coli were sensitive to Meropenam (58.6%) and Amikacin (57.7%) followed by gentamicin (52.6%), amoxiclav (43.1%), ciprofloxacin (42.2%). Sensitivity & resistance rate in Staphylococcus saprophyticus were same (50%) in Cephradine . Where complete (100%) resistanc e was shown to Ampicillin in Pseudomona s aeruginosa , Klebsiella pneumoniae and Acenatobacter sp. However most of isolates were poorly sensitive to ampicillin (1.7%), erythromycin (2.5%), cefuroxin (3.4%) and amoxicillin (9.5%). This area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for UTIs and their resistance patterns may help the clinician to choose the right empirical treatment. Meropenem, amoxiclav, amikacin, gentamicin, second-generation of both cephalosporins and quinilones are found the most sensitive against the common uropathogens which might be used in the treatment of UTI.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 610-613

The simultaneous occurrence of renal cell carcinoma (RCC) in one kidney & stag horn calculus in another kidney is rare combination. We report a 60-year-old man with concurrent large RCC in one kidney & a complete stag horn stone in the opposite kidney. He was admitted to the hospital because of occasional right loin pain and recently diagnosed hypertension leading to the diagnosis of right renal stone and incidental left renal solid mass in ultrasound scan. Contrast enhanced CT scan revealed 8cm x 6 cm irregular contrast enhanced solid mass(RCC)in the left kidney with extension to perinephric fat and 2.5 cm x 1.5 cm stag horn stone with two small caliceal calculi in the right kidney. Open extended pyelolithtomy(Rt) followed by Laparoscopic left radical nephrectomy were performed. Priority, nature of surgery, and post operative residual renal functional status were among the important considerations in this particular case.KYAMC Journal Vol. 4, No.-2, Jan 2014, Page 423-426