Comparison of STONE Score, Guy's Stone Score, CROES Nomogram, and Seoul National University Renal Stone Complexity Score in Prognosticating Outcomes of Multiple-Tract Mini-Percutaneous Nephrolithotomy: A Retrospective Study.

Objective  The objective of this study was to compare the STONE score (Size of the stone, Topography or location, degree of Obstruction of the urinary system, Number of stones, and Evaluation of Hounsfield units), Guy's stone score (GSS), Clinical Research Office of the Endourological Society (CROES) nomogram, and Seoul National University Renal Stone Complexity Score (RSCS) in prognosticating multiple tract mini-percutaneous nephrolithotomy (mPCNL) outcome. Methodology This descriptive retrospective analysis was carried out at the Urology Department, Lady Reading Hospital, Peshawar, Pakistan. Male and female patients in the age range of 18-70 years who underwent multiple tract mPCNL for renal stones from July 1, 2021, to June 30, 2023, were included in the analysis. Results  A total of 110 patients were registered. Stone-free status (SFS) was achieved in 78.2% (n=86), and complications were observed in 13.6% (n=15) patients. The odds ratio for STONE score, GSS, CROES scoring system, and RSCS for predicting the SFS was 7.093 (95%CI 2.40-20.89), 9.333 (95%CI 2.92-29.81), 11.70 (95%CI 2.56-53.38) and 3.450 (95%CI 1.25-9.53), respectively. Conclusion  Multiple tract mPCNL is a safe and effective technique for the management of renal stones, producing a high stone-free rate. This study demonstrated adequate efficacy and dependability of the four scoring systems in predicting SFS.

Impact of Exogenous Xylanase and Phytase, Individually or in Combination, on Performance, Digesta Viscosity and Carcass Characteristics in Broiler Birds Fed Wheat-Based Diets.

The current study was conducted to evaluate the effects of stored wheat-based diet (1.5 and 2.5 years stored wheat) with and without the supplementation of xylanase and phytase enzymes in combination or individually on performance parameters, digestibility, digesta viscosity and carcass characteristics of broilers. For this purpose, a total of 640-day-old male broilers were randomly distributed to the 64 pens, and each pen had 10 birds. Two basal isocaloric and isonitrogenous diets contained 1.5 and 2.5 years stored wheat were formulated in this experiment. In the current study, experimental feeds were prepared by supplementing exogenous enzymes in both basal diets with xylanase (500 XU), phytase (500 FTU) alone or in a combination of phytase and xylanase. Performance parameters data represents that both in starter phase and finisher phase, inclusion of exogenous enzymes xylanase and phytase in both basal diets alone or in combination enhance the feed intake, and body weight gain (p < 0.05) and improve the feed conversion ratio in overall phase (p < 0.05). Similarly, supplementation of exogenous xylanase and phytase alone or in combination enhance the nutrient digestibility and reduce the digesta viscosity (p < 0.05). Based on the results of this experiment, it is concluded that supplementation of exogenous xylanase and phytase enzymes alone or in combination in wheat-based diets (stored wheat 1.5 and 2.5 years) enhance and improves the performance of birds.

Agreement Between 64-Slice Multidetector CT Angiography and Transthoracic Echocardiography in Detection of Extracardiac Findings of Congenital Heart Disease.

OBJECTIVE: To determine the degree of agreement between multi-detector computed tomography angiography and transthoracic echocardiography in diagnostic evaluation of congenital heart disease with extracardiac findings. STUDY DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Radiology Department, Doctors Hospital and Medical Centre, Lahore, from May to November 2016. METHODOLOGY: Patients with clinical suspicion of cardiovascular malformation were included in the study. All the patients had echocardiography and thoracic computed tomography angiography done to diagnose congenital heart disease. Agreement was labelled in true positive and true negative patients. RESULTS: Computed tomography angiography could detect the extracardiac findings of congenital heart disease in 140 (93.3%) patients, while transthoracic echocardiography in 118 (78.7%) patients. Agreement was detected in 108 (72%) patients. Kappa statistics showed poor agreement (kappa = -0.113). CONCLUSION: Although transthoracic echocardiography is usually the first line of investigation in evaluation of congenital heart disease; it has its limitations for evaluating congenital heart disease with extracardiac findings, due to intrinsic limitation of the imaged field. Computed tomography angiography has better sensitivity in detecting extracardiac findings of congenital heart disease along with better delineation of anatomy.

Weber's syndrome with vertical gaze palsy.

Weber's syndrome with vertical gaze palsy is rarely reported in literature. We present a case of a 47-year-old female who developed sudden onset of left exotropia, right sided hemiplegia and vertical gaze palsy. Magnetic resonance imaging (MRI) showed multiple infarcts involving both thalami and extending caudally into the midbrain. This case presents the diverse clinical picture following midbrain infarcts.