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Horseshoe kidney is a rare congenital anomaly resulting from the fusion of the lower pole leading to medial and caudal deviation of kidneys that pose challenges to successful stone clearance. We evaluated the various patient- and treatment-related factors that can impact successful stone clearance. A total of 34 patients with 36 renal moieties with urolithiasis in horseshoe kidneys from 2015 to 2021 were included with a median age of 38 years (11–56 years). The mean calculus size was 39.27 mm (21–70 mm). Twenty-two patients had left, 10 had right, and 2 had bilateral disease. Twelve patients (33%) had previous interventions done. As per Guy stone score (GSS), 14 patients had grade IV, 16 patients had grade III, and 4 patients had grade II disease. Of these patients, 22 underwent unilateral percutaneous nephrolithotomy (PCNL), 2 underwent bilateral PCNL, 6 had pyelolithotomy, 2 had right nephrectomy, and 2 patients underwent shockwave lithotripsy (SWL). Six patients undergoing pyelolithotomy had complete clearance. In PCNL, infra-costal puncture was done uniformly. Complete clearance was seen in 12 out of 16 with superior calyceal access (75% stone-free rates, SFR), 2 out of 8 with middle calyceal puncture (25% SFR), and both the cases with inferior calyceal puncture (100% SFR). Factors affecting stone clearance are as follows: GSS, i.e., grade < IV vs ≥ IV (71.4 vs 50%, P = 0.42), STONE score < 12 vs ≥ 12 (83.3 vs 28.5%, P = 0.048), stone size < 40 vs ≥ 40 mm (50 vs 71.4%, P = 0.42). Our analysis showed that stone clearance was independent of mode of access, GSS, or stone size, although STONE score was a predictor of successful outcomes in PCNL. [ABSTRACT FROM AUTHOR]

Numerous studies have been done for markers of lung injury especially in animal models and it remains relatively unexplored whether these biomarkers clinically correlate with the outcome of patients or with the extent of lung parenchymal injury as deduced by MDCT. This prospective study was conducted to assess the serum level of Clara cell secretory protein (CC16) and volume of the uninvolved lung by MDCT and to ascertain the correlation between levels of CC16 with the volume of the injured lung in the clinical outcome of patients of blunt thoracic trauma. Serum CC16 levels and mean uninvolved lung volumes of both lungs were compared in between groups of eventless recovery, need for mechanical ventilation and mortality with p value < 0.05 considered to be significant. Sixty-two patients of blunt chest trauma, age range from 18 to 60 years, were evaluated in our study. Out of them, 43 (69%) were male. Higher level (more than 100 ng/mL) of serum Clara cell protein was associated with the requirement of ventilator and mortality. Total mean uninvolved lung volume of 1075.71 ± 327.5 and 2329.23 ± 776.01 was significantly associated with the requirement of mechanical ventilation and eventless recovery of patients respectively. A mild negative correlation (− 0.4) between the remaining volume of the lung after injury and serum Clara cell protein levels were also noted. Serum CC16 levels may obviate the need of MDCT in the selected group of patients and thereby avoiding its radiation hazards. [ABSTRACT FROM AUTHOR]