Autologous arteriovenous fistula is gold standard to maintain vascular access for hemodialysis patients. As per the Kidney Disease Outcomes Quality Initiative guidelines, distal veins are preferred as the first choice. In this study, a total of 134 patients and 138 fistulas were evaluated from April 2015 to March 2016. Demographic factors and clinical factors were taken into consideration. Our study showed that age, sex, diabetes, and type of construction (end-to-side vs. side-to-side) had no influence over fistula patency rates. Intradialytic hypotension was one of the risk factors for loss of fistula patency. Smoking and history of hypertension were associated with reduced patency rates (P<0.001). Primary failure was more with distal fistulas (15.2%).

Aim:The aim of the study is to identify the prevalence of metabolic abnormalities in children with urolithiasis.Materials and Methods:This is a prospective study; all children below 15 years who are found to have urolithiasis were prospectively evaluated with relevant history, clinical examination, and urine and serum testing. Metabolic workup includes complete urine examination, urine culture and sensitivity, and 24-h urinary analysis (lithorisk profile).Results:A total of 55 patients are included in the study. Forty-two are boys and 13 are girls aged between from 8 months to 15 years. Thirty-three patients underwent stone analysis, primary composition of calcium oxalate stones in 19 (58%), ammonium urate in 4, dahlite in 3 and uric acid in 3, silicon oxide in 2, and struvite in 2 cases. Lithorisk profile was performed in 40 cases (72.7%). The pH range is 5.6–6.2. We noted hypercalciuria in 20 patients (50%), hyperuricosuria in 23 (57.5%), hyperoxaluria in 20 (50%), hypernatriuria in 26 (65%), hypocitraturia in 9 (23%), and hypomagnesuria in 3 (7.5%). Urine calcium-to-creatinine ratio >0.2 was found in 22 (55%) patients. Statistically significant association between hyperoxaluria and hyperuricosuria (P < 0.04, r = 0.32) and hypercalciuria and hyperuricosuria (P < 0.001, r = 0.51) found in this study. Hyperuricosuria is seen in 75% and 73% of patients with hypercalciuria and hyperoxaluria, respectively. Twenty-five children have both lithorisk profile and stone analysis. Hypercalciuria and hyperoxaluria were noted in 60% of calcium oxalate stone formers each. Elevated urinary calcium/creatinine ratio (>0.2) was seen in 73% of calcium oxalate stone formers.Conclusion:Because of high prevalence of metabolic risk factors and the significant risk of lifelong recurrence, all children with urolithiasis need complete evaluation with metabolic workup.

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Blunt penile traumatic injury is usually of concern only with an erect penis, when fracture of the tunica albuginea may result. Here we report a case of fracture penis with an atypical presentation.

Introduction: Urethral stricture is "narrowing of the caliber of the urethra caused by the presence of a scar consequent to infection, inflammation or injury". Urethral strictures are difficult to manage. BXO is more resistant to all types of treatment and recurrence is the most common complication. Buccal mucosa dorsal onlay graft urethroplasty is one of the surgical treatment modality for treating BXO related strictures. Objective and Methods: This study is to assess the outcome of stricture urethra in BXO cases treated by single stage buccal mucosa substitution urethroplasty. A Prospective study, total 35 patients underwent surgery for stricture urethra with BXO. Results: 33 patients underwent single stage dorsal onlay buccal mucosa substitution urethroplasty and 2 patients underwent augmented roof strip buccal mucosa urethroplasty Pre and post operative uroflowmetry done for all patients, a significant increase in post-operative uroflowmetry rates observed (P value is less than 0.0001.). Patients were followed up post-operatively at 3, 6, 9, 12 and 36 months intervals out of 35 patients 6 patients had the recurrence. Out of 6 patients, 3 patients underwent one single procedure for recurrent stricture. the success rate is 91.42%. (mean followup period 36.2 months). Conclusion: Buccal mucosa dorsal onlay urethroplasty a good surgical option for BXO patients with less recurrence rate.