Background: The worldwide prevalence of developing renal stones is as high as 15% with an estimated 1 in every 5 persons being affected with the condition in Pakistan. Among the many treatment options available for renal calculi, extracorporeal shockwave lithotripsy (ESWL) is among the commonest owing to its non-invasive nature, however, it has its drawbacks; one being limitation against dense stones.   Objective: To assess association between stone density (detected on CT KUB) and ESWL outcome among patients with renal calculi. Methodology: This clinical trial was conducted upon a sample of 150 patients (of either gender, aged 16 to 70 years) presenting to the Urology out-patient, emergency and lithotripsy department of Ziauddin University Hospital with renal calculi from 30th August 2017 to 30th September 2019. After taking written informed consent, data was recorded onto a prestructured questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, and disease history, inferences obtained from C.T KUB, operative notes and the eventual treatment outcome. The data obtained was analyzed using SPSS v. 21.0.  Results: The mean age of the sample stood at 36.7 (SD ± 3.1). 104 (69.3%) patients had multiple calculi and 46(30.7%) have single calculi with mean density of 812 (SD ± 219) HU. A (having stone density <500-HU) group B (having stone density 501 to 1000-HU) and group C (having stone density >1000-HU). The success of group A was 95.34% group B was 88.5% and group C was 80.3%. Major proportion of the sample (39.3%) required up to 3 ESWL sessions. The stone density was observed to be inversely proportional to the success of ESWL.  Conclusion: After careful consideration, it can be concluded that higher stone density is associated with a poor ESWL outcome and thus other treatment modalities may be considered among patients with a stone density of more than 900 HU.

Background: A common indication in urological pathologies and especially in instances of ureteric calculi/obstruction, is the placement of ureteric catheter such as the double J stent. 76% of patient with double J stent may encounter adverse outcome owing to bacterial colonization of their stents. Though antibiotic administration may help counter the situation, the implicated microorganisms are hard to determine. One may suggest that a urine culture may offer insight into the matter, however, little is known how bacteriology of the urine and stent culture resemble and thus a comparative analysis is much needed. Objective: To compare the bacteriologic profile of urine and stent culture to determine the incidence and etiology of bacteriuria among patients with ureteric double J stent. Methodology: This cross-sectional analysis, was conducted upon a sample of 219 patients (of either gender, aged 10 to 70 years) presenting for ureteric double J stent removal from June 2021 to February 2022 at Ziauddin University Hospital, Karachi. After taking written informed consent, data was recorded onto a pre-structured questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, bacteriological profiles of the urine and ureteric double J stent culture. The data obtained was analyzed using SPSS v. 21.0. Results: Among the sample 51.6% of the patients were males, while the remaining 48.4% were females. The mean age of the sample stood at 38 (SD ± 9.1). The total incidence of bacterial colonization was seen in 61.64% and 19.6% of stent and urine cultures respectively, with Enterococci being the commonest (54.8%) organism in stent culture and Pseudomonas Aeruginosa being the commonest (32.6%) in urine culture. Conclusion: After careful consideration, it can be concluded that the incidence of bacterial colonization among both cultures, in addition to the detailed bacteriological profiles of urine and ureteric double J stent culture differ considerably and urine culture may not serve as an ideal indicator of stent colonization and antibiotic prophylaxis should continue to be practiced among symptomatic patients despite a sterile urine culture.