To review & evaluate the clinical presentation & surgical complications of Xanthogranulomatous Pyelonephritis (XGP). Objectives: XGP is usually considered as an uncommon destructive chronic inflammatory disease of the kidney. The disease is usually diagnosed only on postoperative histopathological reports of the surgically excised tissues and has given less emphasis on preoperative diagnosis. We retrospectively reviewed biopsy proven diagnosed cases of XGP over the past 7 years, with a specific emphasis on preoperative clinical presentation of the patients, to help improve the preoperative diagnosis of XGP. Study Design: Case Series study. Setting: Department of Urology Sandeman Provincial Teaching Hospital Quetta. Period: 7 years July, 2011 to June, 2018. Material & Methods: We retrospectively reviewed all biopsy proven cases of XGP who underwent surgery in the department of Urology of a tertiary care hospital from July, 2011 to June, 2018 regarding clinical characteristics, laboratory & radiological finding, interoperate & postoperative complications. Results: There were 42 patients of XGP. The mean age was 49.8+-16.04 years. Male & female percentage was 40.50 & 59.50 respectively. Majority (88.1%) of patients were of low socio-economic status. The most common presentation was flank pain in 100% patients. Fever & dysuria in 64.28%, anorexia in 85.71% and weight loss in 83.33%. In laboratory findings, pyuria was present 88.09%, anemia in 71.42%, azotemia & abnormal liver enzymes in 14.29% each. The most common associated conditions were renal calculi in 83.33% and diabetes in 47.61%. The commonest organism isolated on culture was E-Coli in 35.48%. Intra-operatively excessive bleeding occurred in 3(7.14%), including one with tear of inferior vena cava. Two patients suffered colonic injury & another one pleural injury. Postoperatively the common complications were, wound infections in 8(19.04%) patients & Incisional hernia in 2(4.76%) patients. Conclusion: Urolithiasis and urinary tract infection are two well known risk factors for the development of XPN. Our experience in the present series, demonstrates that low socioeconomic status could be another risk factor for XPN. Early diagnosis and proper treatment of urolithiasis & urinary tract infection is important to prevent their complications including XGP.

This study aims to explore the relationship between the perception of home demands, demography and mental health of married women during the COVID-19 pandemic. The predictive role of perception of home demands, and demographics has also been assessed, in determining the mental health of married women during the pandemic. A sample of 250 married Pakistani women, between 20 to 55 years, with at least one child and minimum matric qualification, were included in the study. Participants were administered a self-constructed questionnaire. Regression analysis showed that quantitative home demands and husband’s employment status were significant negative predictors of anxiety and depression in women, whereas emotional home demands and mental home demands were significant positive predictors of depression, anxiety, and stress in married women. The results of this study help to highlight the work pressure women are facing during the pandemic and to support reform in balanced gender role expectations in society. This study also has implications for mental health practitioners, feminists, social workers, psychologists, and policymakers. Keywords: Perception of Home Demands, Mental Health, Married women, COVID-19.

Objectives: To compare the success of slow rate with fast rate extracorporeal shock wave lithotripsy in patients undergoing treatment of urolithiasis. Study design: Randomized controlled trial Place & Duration of Study: This study was conducted in Urology Department of Sandeman Civil Hospital, Quetta for one year duration from 1stApril 2020 to 30thMarch 2021. Methods: Total ninety patients who were divided in two equal groups i.e. Group A in which patients received treatment with slow rate extracorporeal shock wave lithotripsy and group B in which patients received treatment with fast rate extracorporeal shock wave lithotripsy. Results: There were 32 (71.1%) male patients and 13 (28.9%) female patients in group A. In group B, there were 28 (62.2%) male patients and 17 (37.8%) female patients. Mean age in group A was 35.61+4.19 years while in group B, the mean age was 34.11+69.32 years. The success rate of slow rate extracorporeal shock wave lithotripsy was 36 (80%) and that of fast rate extracorporeal shock wave lithotripsy was 21 (46.7%) (p-<0.05). Conclusions: The slow rate extracorporeal shock wave lithotripsy is better than fast rate extracorporeal shock wave lithotripsy for elimination of urolithiasis. Keywords: Extracorporeal shock wave lithotripsy, Slow rate ESWL, Fast rate ESWL