Occupational hazard in urolithiasis patients in Qatar: A single-center cross-sectional study.

BACKGROUND: Urolithiasis is one of the most prevalent urological diseases and is associated with a substantial economic burden. Its prevalence varies according to geographical location. Qatar is a Middle Eastern country located in the Afro-Asian Stone Belt. It has a dry and hot climate, which may predispose individuals working in these environments to form kidney stones (KSs). METHODS: A population sample of 4204 patients was categorized into five occupational classes. The frequencies and correlations of these occupations with KS formation were calculated. RESULTS: Among the total cases, 2000 presented with KSs, with the majority being of Asian descent (49%), followed by individuals of Middle Eastern descent (35.1%). Technicians accounted for 35.15% of KS cases followed by clerks (29.2%) and executives (14.6%). Among KS cases, 44% had a single stone, 30% had multiple stones, and 26% had two stones. In comparing both KS and non-KS groups, age, gender, occupation, and race were significantly associated with KS formation (p<0.05), while BMI did not show any significant correlation (p>0.05). Asian males aged 31-40, working as technicians, were significantly more prone to urolithiasis. In comparing age, BMI, and gender with stone characteristics, only age was found significantly associated with stone size (p<0.05). Occupation showed an impact on all studied stone characteristics. Clerks and technicians presented more frequently with stones within the 11-15 mm range, while executives more frequently presented with smaller stones (p<0.001). Stone density was more frequently <500 HU in workers, technicians and housewives and >500 HU in executives and clerks (p<0.001). CONCLUSIONS: Our findings revealed an elevated risk of urolithiasis among certain occupational groups, particularly technicians, who frequently work outdoors in high-temperature environments. Alternatively, the sedentary nature of clerical and executive positions can also contribute to the risk of urolithiasis.

Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis.

OBJECTIVE: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. MATERIALS: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. RESULTS: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. CONCLUSIONS: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis.

The sclerosing Sertoli cell tumor of the testis is an extremely rare entity.

We present the case of a 31-year-old single male patient, who was admitted through emergency unit with painless hard nodule of his left testis of 6 months' duration. Ultrasound scan of the scrotum showed a fairly well-defined hypo echoic area in the left testicular parenchyma in its middle part, measuring approximately 10 × 9 mm in size. We performed left inguinal radical orchidectomy. Histopathology examination of the left testis revealed sclerosing Sertoli cell tumor (SSCT) of the testis. This is a very rare testicular tumor with very few published case reports. Systemic examination was performed to exclude systemic metastasis. SSCT is characterized by the presence and aggregates of tubules of Sertoli cells, separated by a sclerotic intercellular matrix formed by fibrotic connective tissue.

Is There Any Improvement In Efficacy Of Xtracorporeal Shockwave Lithotripsy Therapy For Treating Renal Stones With Invent Of New Shockwave Machines?

BACKGROUND: Renal stone disease is a very common medical problem in general population. As with invent of newer therapeutic modalities, ESWL is already losing its popularity. But we believe it as an effective way of treating renal stones. This study was conducted to evaluate any improvement in success rate of ESWL therapy for treating renal stones with latest shockwave lithotripsy machines. METHODS: Study conducted from June 2016 until November 2017 in Alkhor hospital, Hamad Medical Corporation, Qatar. All patients undergoing ESWL for renal stones in mentioned period were included. Total 197 patients underwent ESWL using newer machines. Factors already studied to affect the success rate like stone size, location, consistency (measured by Hounsfield units on CT), presence of stent were taken in consideration. After a period of 3 months either complete stone clearance or stone fragments smaller than 4 mm were considered as a treatment success. These results were compared to the results from literature. RESULTS: Patients were followed until 3 months after treatment. 170 patients (86.29%) had complete stone clearance. Eleven patients (5.58%) had residual stone less than 4 mm, thus achieving an overall success of 181 patients (91.88%). 42 patients (21.32%) needed repeat session of ESWL with a maximum number of 3 sessions. 16 patient's (8.12%) required auxiliary procedures like flexible ureteroscopy. Post-ESWL complications were recorded in 12 patients (6.09%). Success rate was affected mainly by stone size with negligible effect of stone location. Presence of stent affected the number of sessions but has no impact on stone clearance.. CONCLUSIONS: Although the stone size and to a negligible extent, the stone location and presence of stent may affect the stone clearance, nevertheless a significant improvement in success rate has been observed by use of new shockwave lithotripsy machines.

Percutaneous nephrolithotomy in complete supine flank-free position in comparison to prone position: A single-centre experience.

OBJECTIVES: To assess the outcomes of performing percutaneous nephrolithotomy (PCNL) in a modified supine position, more feasible for surgeons, anaesthetists, and operating theatre staff, as well as for the patient himself, and evaluating it in comparison to the standard prone position. PATIENT AND METHODS: A retrospective, case-control study was conducted between January 2011 and December 2015. In all, 197 patient's records were reviewed. The initial 101 patients were operated upon in prone position. From mid-2013, 96 patients were operated upon in a complete supine, flank-free position. The groups were compared in terms of operation time, calculated from positioning the patient after anaesthesia induction, insertion of ureteric catheter, puncture of renal system, until the end of procedure; stone-free rate; hospital stay; and postoperative complications, such as transfusion rate, fever, and urinary leakage. RESULTS: There were two significant differences between the groups. Firstly, the operation time was a mean (SD) 32.3 (6.6) min shorter for the supine versus the prone position (P < 0.001). Secondly, hospital stay was a mean (SD) 1.2 (0.75) days shorter for the supine vs the prone position (P < 0.001). The complete stone clearance rate (85.4% for supine vs 79.2% for prone; P = 0.2) and postoperative complications (7.3% for supine vs 17.8% for prone; P = 0.02) were comparable in both groups. CONCLUSION: Supine PCNL is a feasible procedure with similar outcomes in terms of stone-free rate as well as postoperative complications, to the standard prone PCNL. It reduces unnecessary delay that occurs during change of position resulting in significant shortening of the total operation time and surgeons can perform supine PCNL whilst sitting.