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Objective: To compare the outcome of single oral dose of ciprofloxacin verses no prophylaxis before minor cystoscopic procedures (diagnostic cystoscopy, check cystoscopy and removal of double J stent) in female patients. Methodology: A total of 180 female patients were prospectively assessed. All patients had documented “no growth” on pre-procedure urine culture. Ninety female patients were randomized as Group A (No prophylactic antibiotics) and Group B (single oral dose of ciprofloxacin). Postoperatively all patients were observed for 4 hours in-hospital and then on telephone for first 3 days of procedure. Parameters including, burning micturition, fever, hematuria flank pain and urinary retention were recorded. Results: Overall the median age was 52.4 years (23-74 years), the mean age in group A was 52+6.1 years and in group B was 49.2+7.4 years. There was no statistically significant difference in both groups. In terms of co-morbidities, there was no statistical significant difference in both groups. Majority of our cystoscopy indications were ureteral stent removal, diagnostic cystoscopy and check cystoscopy for surveillance of bladder tumor, both groups were statistically comparable (p=0.09). Post-procedure, majority of patients from both groups remained asymptomatic (group A = 80%, group B =83%). Dysuria was reported by 17.7% of group A patients and 15.5% of group B patients, statistically it was comparable in both groups. Only 3 patients had culture proven urinary tract infections. Conclusion: There is no difference in patients proceeding for day care cystoscopy procedures with or without taking prophylaxis. Double J stents removal, diagnostic cystoscopy and check cystoscopy can safely be performed without antibiotic prophylaxis. Dysuria can happen up to 17% of patients without prophylaxis. Key Words: Antibiotic Prophylaxis, Cystoscopy.

Urethral stricture disease has significant economic impact throughout world. The bulbar urethra is the commonest site for urethral strictures (Approx 50%) followed by penile urethra in most of the published literature. In developing countries trauma (road traffic accident and iatrogenic) is the leading cause of urethral stricture disease. Younger patients have usually idiopathic type as compare to old age group, which present more frequently with iatrogenic and trauma related urethral strictures.This Qausi Experimental study was conducted from May2012-June2016 of duration at Liaquat National Hospital Karachi. All the patients diagnosed with short urethral strictures related to bulbar urethra were included in this study. All the patients underwent non transecting bulbar urethroplasty. All patients were assessed preoperatively, peri-operatively and postoperatively and on follow-up visits as; on 2nd, 8th and 24th week. All the data regarding outcome was recorded on the Performa and analyzed on SPSS V20.Total of 179patients were included, mean age was 38±SD15.3years (range 20- 65years). Anatomically bulbar urethra was affected in 52% of the cases followed by bulbopenile, bulbomembranous region. Etiologically idiopathic type was found in 40% cases, while trauma 21%, iatrogenic injury 26% and UTI 13% were also reasons. Stricture length was mean1.1±SD 1.4 cm (range 0.5-2.5cm). Preoperative Uroflowmetry revealed mean Qmax of 10.5±SD 5.3 ml/sec. Mean operative time was 35±SD 4.6 minutes, 7 patients had conversion to other procedures (3.91%), Postoperative complications were minimal. Mean follow up was 12±SD 21 months (range 6 months to 3 years). On initial follow up at 8th week and 24th week, Qmax was significantly improved. Only 3 patients required DVIU after the 24th week. Initial success rate after 24th week was 98.3% and eventually 100% at the long-term follow-up.non-transecting anastomotic bulbar urethroplasty (NTABU) is a new standard of care for the short bulbar urethral stricture up to 2.5cm. Idiopathic aetiology, iatrogenic and posttraumatic urethral strictures in selective patients can safely be operated with this technique.

Objective: To determine the pulmonary hypertension in chronic kidney diseases Patients And Methods: The one year cross sectional study was conducted at tertiary care hospital. All the patients either gender who were diagnosed as chronic kidney disease were included in the study. These patients were allowed to undergo necessary investigations and treatment. PH was defined as a mean pulmonary artery pressure ≥ 25 mmHg. All the specific patients had thorough clinical history, relevant clinical examination and important investigations to explore the pulmonary hypertension while the frequency / percentages (%) and means ±SD computed for study variables. Results: During one year study period total fifty patients with chronic kidney disease were explored and studied. The frequency for male and female population was 28 (56%) and 22 (44%) with mean ± SD for age of male and female individuals was 55.82±7.83 and 53.72±8.75 respectively while the mean value for pap (mmHg) was 37.72 ± 9.95. gender male 28 (56%) and female 22 (44%), diabetes mellitus 30 (60%), hypertension 32 (64%) and pulmonary hypertension 29 (58%). Conclusion: We presume that PH is a noteworthy issue in ESRD patients. Keywords: Pulmonary hypertension, Renal and Lung.

Objective: To determine the spectrum of pleural effusion due to renal pathologies at tertiary care hospital. Patients And Methods: The one year cross sectional study was conducted at tertiary care hospital. All the patients either gender who were diagnosed as chronic kidney disease (on haemodialysis) were included in the study. These patients were allowed to undergo necessary investigations and treatment. All the specific patients had thorough clinical history, relevant clinical examination and important investigations to explore the pulmonary pathology (pleural effusion) while the frequency / percentages (%) and means ±SD computed for study variables. Results: During one year study period total fifty patients with pleural effusion were explored and studied. The frequency for male and female population was 32 (64%) and 18 (36%) with mean ± sd for age of male and female individuals was 59.82±7.83 and 53.85±6.94 respectively. Gender male 30 (60%), female 20 (40%), pleural effusion 32 (64%). The cause includes idiopathic (unknown) 05 (10%), over hydration 15 (30%), heart failure 06 (12%), parapneumonic effusion 08 (16%), uremic pleuritis 05 (10%), tuberculous pleurisy 06 (12%), malignancy (prostate cancer) 05 (10%). Conclusion: Pleural effusion is regular in hospitalized patients getting long haul hemodialysis due to chronic kidney disorders. Keywords: Pleural effusion, Kidney, Lung and Renal disease.

Objective: To determine the efficacy of Alpha blocker as adjunctive medical therapy , which increases the stone clearance afterextracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Design: Quasi Experimental study. Setting: Department of Urology,Liaquat National Hospital, Karachi. Period: September 2010 to March 2011. Materials & Method: Ultrasound guided Dornier Alpha Impactlithotripter was used for shock wave lithotripsy. Study was carried out on 60 patients who underwent single session of ESWL for renal calculus.Patients were divided in two groups, Group A (n=30) received conventional treatment and Group B (n=30) received Alpha-1 Blocker in additionto conventional treatment. All patients were evaluated with X-ray and Ultrasound (KUB) after 2 weeks and repeated at the end of month. Failureis defined as unsuccessful expulsion after 4 weeks and patient desire to remove the stone before day 30. Result: Out of 60 patients, 45(75%)were males and 15(257%) were females with male to female ratio was 3:1. The average age of the patients was found 36.32 ± 14.8 (Rangingfrom 15 to 75) years. Complete clearance was achieved in 76.7% of those receiving Alpha-1 Blocker and in 46.7% of controls at 1 month (P =0.001). This difference was statistically significant. Conclusions: The results of my study demonstrate that Alpha-1 Blocker therapy, as anadjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equallysafe.

To compare the stone clearance of upper with middle and lower ureteric stones by using ureteroscopic pneumatic lithotripsy.The study was conducted in the Department of Urology, Liaquat National Hospital, Karachi, from February 2009 to February 2010. A total of 90 patients were selected and divided into three groups of 30, each according to the location of stone in the ureter. All patients underwent ureteroscopic pneumatic lithotripsy with 8.5 Fr Wolf rigid ureteroscope and Wolf 2mm probe used for stone fragmentation. All patients were evaluated with X-ray KUB, ultrasound KUB and IVU. Follow-up studies included X-ray and ultrasound KUB performed on 1st postoperative day, after 1 week and at the end of 2nd week. Presence of stone after last follow-up was considered as failure of the procedure.Total number of patients were 90 and mean age was 27.47 +/- 5.8 years. Male female ratio was 2.1:1. Mean stone size was 11.44 +/- 1.41mm. According to the location of the stones, the success rate of pneumatic lithotripsy for upper, middle, and lower ureteral stones was 86.7%, 93.3%, and 96.7% respectively. Completely fragmented stones cleared spontaneously within two weeks in 83 of 90 cases so the overall stone-free rate was 92.2%.Ureteroscopic Pneumatic Lithotripsy is an acceptable form of treatment for upper ureteric calculi in addition to middle and lower ureteric calculi. It is a simple, reliable, effective, rapid and safe procedure.