Background: Urinary retention is one of the common urological emergencies and conventional ‘blind’ SPC frequently used comfortable as well superior procedure for patients. During conventional SPC, the distended bladder is identified by palpation or percussion without proper attention to intervening bowel segment and other structures. However, the recently published data suggests that if, ultrasound is used during SPC, and it identifies not only bladder but also intervening bowel segment which complications. Therefore, the objective of this study was to assess and compare the perioperative complications of both methods.Methods: This prospective study was conducted between years November’2017 to June’2019. Sixty patients (n=60) of urinary retention were randomized to undergo ultrasound guided or conventional SPC procedures. Patients were divided into two equal groups of 30 patients in US-SPC (Group-A) and C-SPC (Group-B). After either SPC, the patients were closely observed for development of complications.Results: Overall, the patients had mean age of 53.87+21.418 and 53.87+21.418 years in C-SPC and US-SPC group, respectively. Mean operative time and subsequent initial urine drainage were almost equal in both groups. However, in C-SPC group, 5(16.7%) patients developed complications in the form of 03 misplaced catheters outside bladder, 01 into retro pubic space and another 01 into rectum. All patients in Group-A required ultrasound guided revision of SPC compared to none in Group-B.Conclusion: Overall, the ultrasound-guided SPC (US-SPC) is safer procedure compared to conventional ‘blind’ C-SPC in relieving urinary retention in emergency, thus it should be recommended procedure whenever need arise for SPC procedure.

No abstract

Neurosurgical procedures in infants poses various challenges such as difficulty in venous cannulation, securing invasive vascular lines, difficult airway, controlling intra-cranial tension, managing large fluid shifts to positioning- related issues and temperature maintenance. We hereby present an case of a large intracranial space occupying lesion, suspected to be a hydatid cyst, which later turned out to be an infected ventricular cyst and intraoperative problems. A thorough preparation prior to operation of infected cystic lesion of the brain is required including anticipation of massive blood loss and its management. A slow decompression of the large cystic lesion should be done.

No abstract

Background: Over the time, the nephron sparing surgery (NSS) has become 'gold standard' for treatment of T1a stage renal cell carcinoma (RCC) which saves precious renal tissue. We assessed and compared perioperative morbidities associated with open (ONSS) and robotic nephron sparing surgery (RNSS) in patients of T1a and T1b staged renal cell carcinoma. Methods: This prospective study was carried out from April 2016 to March 2018. A total of fifty (n=50) RCC patients underwent open or robotic nephron sparing surgery. The demographic data and perioperative morbidities associated with both methods of NSS were recorded and comparison of parameters including warm-ischemia time (WIT), hospital stay, perioperative bleeding, impact of renal-pedicle clamping was made in T1a and T1b staged RCC patients. Results: The most common perioperative morbidity was blood-loss and 12% patients had ≥500 ml loss. Significantly less intraoperative blood-loss was observed in RNSS compared to ONSS with decreased blood transfusion (BT), which decreased significantly after renal-pedicle clamping prior to RCC resection. Even In perioperative period, the blood loss was significantly less in RNSS patients. However, the warm ischemia time (WIT) and hospital stay was longer in patients of RNSS compared to ONSS. The WIT was prolonged in T1b compared to T1a lesions, irrespective NSS methods. Conclusions: Although, the most common perioperative morbidity associated with NSS is blood-loss but RNSS had less perioperative morbidities compared to ONSS. The blood loss decreased significantly during intraoperative period after renal-pedicle clamping which resulted into decreased blood transfusion after NSS by either method.

No abstract

No abstract

No abstract