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ABSTRACT Background and objectives: Among many lithotripters for fragmentation of ureteric stones, pneumatic and Holmium: YAG laser lithotripsy has reported favorable outcomes. The aim of this study is to compare the efficacy of pneumatic lithotripsy with laser lithotripsy in ureteral stone. Materials and methods: In this prospective study, 60 patients with diagnosis of ureteral calculus underwent ureteroscopic lithotripsy in Urology Unit, Department Surgery, National Medical College and Teaching Hospital over period of 2020 to 2021. They were divided randomly into two groups, each group with 30 patients. Group PL was treated with Pneumatic lithotripsy and Group LL was treated with Holmium: YAG laser lithotripsy. History and detailed clinical examination was performed as per the working proforma which included. Result of both the procedures was assessed. Chi square test were used for correlation analysis. Data analysis was done using SPSS (Statistical Package for social sciences), version 25. Results: Mean age was 26.5 years and 36.33 years in group PL and LL respectively (P=0.58), there was no significant difference in male to female ratio and mean stone in both groups. Duration of operation was significantly lower in LL group and Hospital was slight lower in LL group as compare to PL group (0.95). Conclusion: Ho:YAG laser and pneumatic lithotripsy are efficient and safe procedures for ureteral stones. Though operative time is higher in pneumatic lithotripsy.

Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard first-line treatment for renal stones. It a successful, less invasive surgery (> 90%) but with high complication rate (> 10%). The study aims to see the outcome of PCNL in patients with renal stone who were treated. Materials and Methods: A retrospective study which included all the cases that presented with renal stone and who underwent PCNL for the treatment. The data included in this study was from April 2019 to December 2021. Ethical clearance was obtained from the institutional Review Committee (F-NMC/578/078-079). The data were collected from the records available in the record section We evaluated the distribution of presentation, puncture site, stone clearance, blood loss, postoperative stenting and complications of the surgery. Results: The total of 63 cases underwent PCNL in our institute. The mean age of the patients was 34.68±14.108 years and mean size of the stone was 5.7531±18.07804 cm3. Among the total cases, 52% cases presented with renal stone on the left kidney, 54% presents in the pelvic ureteric junction. In 71% cases puncture was made in the lower pole and in 63.5% single puncture was made to proceed. Complete clearance of stone was seen in 94% cases, 4.8% developed urosepsis and 6.3% required blood transfusion. Stenting was done postoperatively in 95% cases. Conclusion: The total stone clearance rate in our study was 94% which higher when compared to other study. With the increase in case flow the efficacy of the procedure will increase and along with this the outcome of the procedure will increase.

Introduction All endoscopic surgery in urology needs irrigant fluid for clear visibility and to wash out the blood and debris. Glycine 1.5% is widely accepted but sterile water is cheaper and easily available. All types of irrigants are responsible to cause electrolyte disturbance to different degrees. In our study, we compare the glycine 1.5% with sterile water as irrigant fluid. Materials and Methods In this prospective observational study, 64 patients were included with 31 patients in the sterile group and 33 patients in the Glycine group. Hemoglobin, sodium, potassium was analyzed postoperatively after 6 hours. Weight of prostate, resection volume, the volume of fluid, and resection time was calculated. Results There were changes in the parameter of hemoglobin and sodium but were not statically significant whereas the change in potassium was statically significant in both groups. Conclusion Sterile water is a safe inexpensive and easily available fluid for TURP as compared to glycine 1.5%. The study did not show any significant difference in using both fluids our sample size was small so needs a similar study with a large sample size to confirm the observation.

Introduction Laparoscopic cholecystectomy is clean-contaminated surgery. Prophylactic antibiotics are used to reduce SSI but there is still controversy regarding use of antibiotics in postoperative period. The aim of this study is to compare the effect of single dose versus multiple doses of antibiotics in terms of wound infection. Methods This prospective study was carried out in department of surgery of National Medical College and Teaching Hospital, Birgunj from March 2020 to March 2021. Patients with diagnosis of symptomatic cholelithiasis were divided using lottery method in single dose (SD) group and multiple doses (MD) group. SD group were given injection ceftriaxone 1gm at the time of induction of anaesthesia and MD group received injection ceftriaxone 1gm at the time induction of anaesthesia and followed by continuation of same dose twice a day for 2 days. Results A total of 249 patients completed the study among which 127 patients were included in the (SD) group and 122 patients in (MD) group. The mean age of patient was 37.37±14.30 years. In single dose (SD) group, 4(3.1%) patients developed wound infection and 3(2.5%) patients in multiple (MD) group developed wound infection which was not statistically significant (p=0.437). Conclusions Single dose antibiotic was found to be as effective as multiple doses of antibiotics in terms of wound infection in laparoscopic cholecystectomy.