Aims and object: To assess the aetiology and management of Fournier's gangrene. Methodology: We examined 30 paients retrospectivdely, during the period from 2015 to 2020, the patients from the Urology department of CMC Hospital at SMBB Medical University Larkana. All the related data were taken as well as demographic details, history and risk factor from the patients regarding illness. Routine investigation carried out including Blood CP ESR, Urine Dr, Blood sugar, Renal profile and pus culture sensitivity. 20 patients under gone for surgical debridement, 5 patients require skin grafting and 4 patients requires testes burrial after recovery under aseptic measures. Result: 30 male patients with mean age 20±10.5 year. Majority (80%) of patient presenting with necrotising infection on scrotum,perineum and hypogatric area. Basic laboratory investigations including Blood CBC showed mean WBC 15000/cmm3, mean Hb was 8.5 gms, Urine analysis showed pyuria and haematuria, pus culture and sensitivity positive in 90% cases and most prevalent organism was E.Coli, Mean Blood urea was 35mg and serum creatinine was 1.9mg. Commonest causes of fourneir gangreen was trauma, UTI, urethral stricture, indewelling catheter and perianal abcess and D.M was commonest comorbidity). All patients treated by surgical debridement while 5 patients requires skin grafting and 4 patients requires testes burrial after recovery under aseptic measures with with triple regimen antibiotics. Conclusion: Surgical debridment of necrotic tissues and triple regimen antibiotic are the main stay for primary management of Fournier's gangrene (FG) to decrease the morbidity and mortality keywords:

Background: Tuberculosis of the glans penis is a rare occurrence., even in developing nations. Aim and Object: To review the literature and case presentation of Tb of glans penis Methodology: Pakmedinet, Pubmed and google data were searched for Tb of glans penis. Literature Review: Tuberclosis of the penis can be primary or secondary, and it might look like penile cancer, penile ulcers (granulomatous), genital herpes simplex or HIV infection. Tb of the Penis can develop after a individual who had primary pulmonary Tb and can be spread through ejaculation, contamination of endometerium secretions or clothes, as a result of a previous pulmonary Tb or Tb somewhere else. Tb of the Penis is characterised by a tiny nodule on the penis that is either painless or painful, an ulcer, a mass that progressively increasing and be swelling. Palpation of inguinal lymph nodes and erection problems of the penis can or can not observed. Normally, the patient's voiding is normal. Biopsy or acid fast bacilli in penile discharge or positive Elisa serology or PCR for tuberculosis are used to confirm the diagnosis. Needs 6 months, pulmonary tuberculosis therapy. Conclusions: Tb of the glans penis is an uncommon occurrence. After a biopsy, antitubercular medications are the standard treatment, thus doctors should evaluate the potential of Tb of the penis in instances of penile lesions. Keywords: Tb, penis, presentatation management and review litrarature

Aim: To detect usefulness of triple D score in ESWL (extracorporeal shock wave lithotripsy) for management of renal stone. Methodology: Retrospective Study was conducted at Urology department, CMCTH) at SMBBMedical University Larkana. 50 patients underwent ESWL from 2018 to 2020. All the related data were taken as well as demographic details, history and risk factor from the patients. Routine investigation carried out including Blood CP ESR, Urine DR, Blood sugar, Renal profile, urine culture sensitivity and CT KUB. The stone density, skin-to-stone distance, and stone size were calculated by a radiologist. Results: ESWL was performed on 50 patients with average age of 30± 8 years and a sex ratio (male female) of 1:0.3. The stone-free percentage after the first treatment session was 40 percent and 90 percent on 2nd sitting, based on the triple D score, which included stone size, skin to stone distance, and stone density (HU). The mean stone size was 15.8 mm, the Skin to Stone Distance was 6.4 cm, and the stone density was 594 HU were established respectively. Conclusion: The Triple D Score is easy to compute and reported by radiologist. The use of the Triple D Score in ESWL patients has been shown to improve overall ESWL success rates. Keywords: Extracorporeal, Shock, Wave, Lithotripsy, Renal stone and Triple D score