The pure silicone catheter is advantageous over the silicone coated latex catheter in terms of incidence of bacterial colonization as well as the biofilm formation and hence in the management of CAUTI.

PurposeManagement of patients with complex multiple renal calculi has always remained challenging and they pose many difficulties during percutaneous nephrolithotomy (PCNL) like higher incidence of residual calculus and multiple tracts requirement. The aim of our study was to evaluate the impact of pelvicalyceal system (PCS) anatomy, stone distribution and the site of puncture on the outcome of PCNL in patients with complex multiple renal calculi.Materials and methodsOne hundred and ten patients with complex multiple renal calculi undergoing PCNL during January 2015 to December 2015 were enrolled in our study. Pelvicalyceal anatomy and the stone distribution were determined from intravenous urography. PCNL was done using standard technique. We evaluated the impact of PCS anatomy, stone distribution and the site of puncture on the surgical outcome.ResultsOf all the studied pelvicalyceal anatomy variables, infundibular width, intercalyceal angle and PCS surface area affected the number of punctures. Stone distribution involving all the three calyces or middle and lower calyces was most unfavourable for achieving complete stone clearance. The middle calyceal puncture was almost equally good as the upper calyceal puncture in achieving stone clearance. With timely multiple punctures done, there was neither significant haemoglobin fall nor creatinine rise.ConclusionPelvicalyceal anatomy, stone distribution and site of puncture impacts the number of punctures required and stone clearance achieved in patients with complex multiple renal calculi undergoing PCNL. Based on these parameters we can predict which patient has a high likelihood of requirement of multiple punctures. With timely multiple punctures done, there is neither significant haemoglobin fall nor creatinine rise.

A 61-year-old male, non smoker presented to our hospital with pain lower abdomen, increased frequency of urination (about 15 times during day and 6 times during the night) and urgency of urination for last 6 months. His pain was dull, continuous, non colicky, non radiating and had no relation to food intake. There was no history of weight loss.On physical examination, a well defined lump was palpable in the umbilical and hypogastic region, globular in shape, of approximate size 6×5cm, had smooth surface and regular margins all around. The rest of the physical examination was absolutely normal. Ultrasonography showed a solid heterogenous mass of size about 10×5cm above urinary bladder. Urine microscopy and urine cytology were absolutely normal. Computed Tomography (CT) of the abdomen showed a hypodense soft tissue density lesion of size 9×5×6cm in supravesical region with obliterated fat planes from the dome of urinary bladder and the lesion extended superiorly up to just below the umbilicus [Table/ Fig-1 Signet ring cell carcinoma of urachus is a very rare tumour. It generally presents as a high grade, high stage tumour and in most of the cases it has regional or distant metastasis at the time of presentation. It is known to have a uniformly poor prognosis. We present here a very interesting and rare case report of signet ring cell carcinoma of urachus in a 61-year-old male who presented with irritative lower urinary tract symptoms and pain abdomen. High index of suspicion led to the early diagnosis and timely surgical intervention. The patient is doing well on follow-up.

In this paper we have considered generalized Emden-Fowler equation,subject to the following boundary conditionswhere γ, β and σ are real numbers, γ < −2, β > 1. We propsoed to solve the above singular nonlinear BVPs with the aid of Haar wavelet coupled with quasilinearization approach as well as Newton-Raphson approach. We have also considered the special case of Emden-Fowler equation (σ = −1,γ = −1 2 and β = 3 2 ) which is popularly, known as Thomas-Fermi equation. We have analysed different cases of generalised Emden-Fowler equation and compared our results with existing results in literature. We observe that small perturbations in initial guesses does not affect the the final solution significantly.

<p class="abstract"><strong>Background:</strong> For unstable dorslolumbar injuries, the controversy in choosing between long versus short segment posterior fixation continues.</p><p class="abstract"><strong>Methods:</strong> 29 patients (13 males, 16 females) with single level unstable thoracolumbar fracture operated by short segment posterior pedicle screw fixation were evaluated retrospectively in terms of kyphosis correction achieved in immediate post-operative period, loss of kyhposis correction at final follow up and clinical outcome on Denis pain scale and any failure of fixation. Average follow up period was 22.07 months (14-40 months).<strong></strong></p><p class="abstract"><strong>Results:</strong> Average age of patient was 35.7 years (15-50 years). Mode of injury was fall from height in 27 patients and road traffic accident in 2 patients. 12 fractures were at L1, 9 at D12, 6 at L2 and 2 at L3. Neurologically 11 had paraparesis, 4 complete paraplegia and 14 were without any deficit. Pre-operative kyphotic angle was 23.023±11.14 (8-50 degrees) which improved to 7.03±4.69 (0-18) post operatively. Kyphosis at final follow up was 11.759±5.901 (2-25). Loss of kyphosis correction at final follow up was 4.79±2.042 (2-10 degrees). Load sharing classification score (LSC) was 6.89±1.345 (4-9). Denis pain scale at final follow up was p1 in 11 patients, p2 in 15 patients and p3 in 3 patients. There was no case of implant failure and only one case had kyphosis correction loss of 10 degrees.</p><p class="abstract"><strong>Conclusions:</strong> Short segment fixation provides stable fixation with good results and there is no correlation between LSC and fixation failure.</p>