Aim:The aim of this study is to compare the outcomes of miniaturized percutaneous nephrolithotomy (mini-perc) and retrograde intrarenal surgery (RIRS) in management of renal stones with a diameter <15 mm.Materials and Methods:This was an open-label prospective study that included a total of 80 cases underwent mini-perc (n = 40) and RIRS (n = 40) between July 2014 and August 2017. The primary outcome objective was stone-free rate, retreatment rate, complications, hospital stay, operative time, and reduction in hemoglobin level. Data were analyzed using SPSS version 16.0 Software.Results:Overall, 80 patients were enrolled in this study. The mean age was 40.12 and 38.20 years, and the mean stone size was 1.15 and 1.30 cm in mini-perc and RIRS group, respectively. Majority of the study participants were males. Overall, mini-perc and RIRS had stone clearance rates of 100% and 95.4%, respectively. Two patients required retreatment in RIRS group. The duration of hospital stay and the rate of complication was similar in both the groups. Operative duration was more in RIRS group. Decrease in hemoglobin level was more in mini-perc group.Conclusions:Results demonstrated that both modalities were associated with high stone clearance rates with minimal complications. RIRS was associated with less reduction in hemoglobin and could be used as standard treatment modality for small renal calculi.

Urban living, once synonymous with better amenities, infrastructural facilities and a higher standard of living, has gradually come under severe strain due to ill-planned and un-restrained growth. Infrastructure development has not kept pace with the rapid expansion of many a tier I and tier II city, leading to congestion, poor quality of water supply, sewerage and housing. The lack of basic amenities reflects on the poor quality of life being led by the average urban dweller. Quality of life is a complex, multi-dimensional concept which is open to diverse interpretations. In its broadest sense, the concept refers to all those factors which improve the 'well-being' of the people. It goes beyond the material indicators of money, access to good and services, infrastructure and so on. The concept is measured using both subjective and objective indicators. While the objective indicators of living standards are easy to measure, the subjective indicators, forming an integral part of an individual's perception of quality of life, are complex. The current study examines the optimal physical attributes desired by the residents of a tier II city. The 28-item scale has been adapted to the SERVQUAL model to study the expectation versus the perception of the quality of life of the residents of the city of Lucknow. The quality of life assessment of the residents can well provide a direction to the planners regarding the factors having the maximum gap and hence, the greatest impact on the urban resident.

No abstract

BACKGROUND Extracorporeal shock wave lithotripsy (ESWL) is well known for its non-invasiveness, effectiveness and minimal morbidity for the management of renal stones. Some generation of lithotripters were associated with significant pain, needing anaesthesia. In modern lithotripters, pain is insignificant making lithotripsy an outpatient procedure (day care). AIMS The present study is aimed to compare the clinical efficacy between four drugs. METHODS AND MATERIALS This was a prospective study of 1000 patients with normal BMI (25-30) who underwent ESWL in the Year 2012-15 at our institute. All the patients with renal stones were randomly divided into 4 groups. Dornier Compact Sigma lithotripsy machine was used in all the patients. Group A was given IM diclofenac sodium (1 mg/kg), 60 minutes before the procedure. In group B, 10 g of EMLA cream; and in group C, 15 g of diclofenac diethylamine gel; in group D placebo (electrode gel) was applied locally. STATISTICAL ANALYSIS Visual analogue scale (VAS) was used to assess the severity of pain for initial 5-10 minutes and after the procedure. A P value of less than 0.05 was considered to be statistically significant. Statistical analysis was done using one way ANOVA and results were compared between four groups. RESULTS All four groups were having comparable age, weight, stone size, number of shock waves delivered and maximum voltage used. In group A total 250 patients (M/F: 177/73), group B 250 patients (M/F: 129/121), group C 250 patients (M/F: 158/92), group D 250 patients (M/F: 162/88). With regard to pain scores, the responses were better in group B. According to location of the stones, majority of the stones were located in pelvis (41.5%), followed by upper (30.5%) and middle calyx (16.8%) and least in the lower calyx (11.2%). Overall stone free rate in our study was 75.5%, with least clearance in lower calyceal stones. 112 patients were stented prior to the procedure. Ureteroscopy and RIRS (Retrograde intrarenal surgery) was done for residual stones after 3 sessions of SWL. Post ESWL complications like pyelonephritis, steinstrasse and renal stone migrating to ureter were 2%, 4.5%, 1.9% respectively. CONCLUSIONS With regard to pain scores, the EMLA cream provided better analgesic effect as compared to other groups. Oral NSAID and occlusive dressing of EMLA offers an effective mode for achieving analgesia with minimal morbidity. This therapy avoids the need for general anaesthesia, injectable analgesics, and opioids along with their side effects.