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Giant vesical calculus is a rare entity. Vesical calculi can be primary (stones form de novo in bladder) or secondary to the migrated renal calculi, chronic UTI, bladder outlet obstruction, bladder diverticulum or carcinoma, foreign body and neurogenic bladder. We report a case of an 85year old male patient who presented with history of recurrent episodes of burning micturition, pain abdomen, straining at micturition and diminished stream. Ultrasonography and X ray KUB showed a large vesical calculus. Patient underwent an Open Cystolithomy and a large calculus of size 9x13cm weighing 310gms was removed. Bladder wall hypertrophy was seen with signs of inflammation. Bladder mucosal biopsy was taken which was normal on histopathological examination. Post-operative recovery was uneventful.

Purpose The purpose of this paper is to investigate by means of finite element analysis (FEA), the effect of polyethylene insert thickness and implant material, under axial loading following TKA. Design/methodology/approach The 3D geometric model of bone was processed using the CT scan data by MIMICS (3matic Inc.), package. Implant components were 3D scanned and subsequently 3D modeled using ANSYS Spaceclaim and meshed in Hypermesh (Altair Hyperworks). The assembled, meshed bone-implant model was then input to ABAQUS for FE simulations, considering axial loading. Findings Polyethylene insert thickness was found to have very little or no significance (p>0.05) on the mechanical performance, namely, stress, strain and stress shielding of bone-implant system. Implant material was found to have a very significant effect (p<0.05) on the performance parameters and greatly reduced the high stress zones up to 60 percent on the tibial flange region and periprosthetic region of tibia. Originality/value Very few FEA studies have been done considering a full bone with heterogeneous material properties, to save computational time. Moreover, four different polyethylene insert thickness with a metal-backed and all-poly tibial tray was considered as the variables affecting the bone-implant system response, under static axial loading. The authors believe that considering a full bone shall lead to more precise outcomes, in terms of the response of bone-implant system, namely, stress, strains and stress shielding in the periprosthetic region, to loading.

Background: The accuracy of the implant placement could be advantageous for reducing intra-and postoperative complications. Objectives: This study aimed to present the clinical issues in actual guided surgeries through the examination of the cases of patients that were treated with computer-guided implant surgery and confirm the accuracy of guided surgery by analysing whether the positions before and after the placement matched. Methods: Intra oral structure of each patient, was scanned using an intra oral scanner (Trios 3Shape, United States of America) and merged with the cone-beam computed tomography (CBCT; GiANO, Newtom, Italy) images. Implant placements (CAMLOG, Germany) were planned, regarding the direction and position, using software (Implant Studio TM , Denmark) and placed using the computer-aided design/computer-aided manufacturing (CAD/CAM) guide surgical template. Then, the fabrication of anatomically accurate abutments of the restoration was done using CAD/CAM zirconia. Postoperative CBCTs were recorded and compared with the preoperative using McNemar's test. Result: Mean angular errors between the preoperative planned implant and postoperative placed implant was 4.81 the mean distance errors between the planned and placed implants were 0.43 mm horizontally and 0.68 mm vertically at the implant neck and 0.81 mm horizontally and mm vertically at the implant apex computer-guided implant surgery also offers some advantages over conventional implant surgery from the prosthetic viewpoint. Findings and Conclusion: This technology is expected to continue to develop, with the prediction that all factors contributing to the inaccuracy of guided surgery such as the surgical guide shape, length of metal sleeve and surgical drill, template supporting problem, and scanning method.

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