Introduction: Surgical management of elderly patients with renal calculi is inherently challenging. We compared the efficacy and safety of percutaneous nephrolithotomy (PCNL) performed under regional anesthesia between elderly patients (age >65 years) and patients aged <65 years. Materials and Methods: Between July 2015 and June 2016, fifty patients aged >65 years with renal stones (size >1.5 cm) were treated with PCNL under regional anesthesia (elderly group). We retrospectively compared the outcomes with those obtained in an equal number of patients aged <65 years (younger group) who underwent PCNL under regional anesthesia. Patients with staghorn stones and pyonephrosis and falling under the American Society of Anesthesiologists (ASA) Grade IV were excluded. Data pertaining to demographic characteristics, body mass index, stone bulk, operative time, tract size, number of tracts required, blood loss, clearance rates, complications, and length of hospital stay were analyzed. Results: The mean age at presentation in the elderly and younger groups was 66.8 ± 2.1 years and 38.7 ± 11 years, respectively; 56% of the patients in the elderly age group had ASA Grade II, whereas 58% in the younger age group had ASA Grade I. The mean stone size and the number of tracts were comparable in both the groups, whereas operative time was slightly longer in the elderly group (58.54 ± 18 vs. 51.98 ± 18 min; P < 0.05). Postoperative complications and stone-free rates (94% vs. 92%, respectively) were comparable in the two groups. Conclusions: Age itself should not deter the treatment of elderly patients with renal stones as PCNL under regional anesthesia is safe and effective in elderly patients; outcomes in elderly and younger patients were comparable in this study.

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Introduction: Retrocaval ureter (RCU) is a rare congenital abnormality, secondary to anomalous development of inferior vena cava (IVC) presenting as ipsilateral obstruction needing surgical intervention. The aim of this article is to present surgical techniques and outcome of transperitoneal laparoscopic ureteropyeloplasty in patients with RCU treated by a single surgeon at a tertiary care center and with review of literature. Material and Methods:We conducted a retrospective, institutional review board approved chart review of patients who underwent transperitoneal laparoscopic ureteropyeloplasty for RCU at our unit between January 2010 and December 2020. A total of 10 patients were identified. Preoperative evaluation involved a computed tomography-intravenous urography in addition to the conventional evaluation. All the patients underwent dismembered transperitoneal laparoscopic ureteropyeloplasty over a Double J stent. Data analyzed included the demographic profile, operative time difficulty if any, postoperative, intraoperative complications and functional outcome.Results: All cases were completed laparoscopically and no open conversion was required. Average operating time was 96.6 minutes ± 8.16. Average blood loss was 71 ± 14.49 mL with an analgesia requirement of 115 ± 33.74 mg. One patient developed postoperative urinary leak and responded to percutaneous nephrostomy drainage. Patients were followed up for 3 to 12 months with a serial ultrasound and a follow-up diethylene-triamine-penta-acetic acid renal scan at 3 months to rule out any anastomotic site obstruction. Conclusion: Transperitoneal laparoscopic ureteropyeloplasty for RCU was associated with minimal morbidity and good outcomes.

With the increase in endoscopic surgery, there is a growing concern about the effectiveness of sterilizing reusable equipment by immersion in 2% glutaraldehyde. Although reports of port site tuberculosis (post laparoscopy) are there in the literature, those of nephrostomy site post percutaneous nephrolithotripsy are not available. We describe the clinical features and treatment of six patients who presented with biopsy-proven skin tuberculosis at the nephrostomy-site for non-healing wound.

Background: Anaemia is a global public health problem. To optimize iron delivery in pregnancy, new intravenous complexes like Ferric carboxymaltose (FCM) have been developed in the few years. This study aims to compare the efficacy and safety of FCM vs the iron sucrose during pregnancy.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shri Maharaja Gulab Singh (S.M.G.S.) Hospital, Government Medical College Jammu, Jammu and Kashmir over a period of 1 year. 100 pregnant females with haemoglobin (Hb) in the range 7-9.9 g/dl between 28 to 36-week gestation, were selected randomly out of which 50 were administered FCM (Group A) and 50 were administered Iron Sucrose (Group B). Hb and serum ferritin were assessed 2 weeks and 4 weeks after treatment and side effects of each drug was studied.Results: The rise in mean Hb level at 2 weeks and 4 weeks in FCM group was significantly higher as compared to Iron Sucrose group (1.09 versus 0.52 g/dl and 1.80 versus 1.09 g/dl, respectively). Similarly, the rise in mean serum ferritin level at 2 weeks and 4 weeks was more in FCM as compared to Iron Sucrose group (144.25 vs 95.84 mcg/L and 121.31 vs 84.46 mcg/L, respectively). The adverse reactions were observed in 30% of patients in FCM group and 48% patients in iron sucrose group.Conclusions: Ferric carboxymaltose was found to be more safe and efficacious as compared to iron sucrose.