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Vesical calculi are unusual in females, and giant calculi (weighing >100 g) are even more uncommon, considering the advances in contemporary diagnostic modalities. The entity is associated with a variety of pestering symptoms--frequency, dysuria, and hematuria, to name a few--causing serious effects on patients' quality of life. This report cites the case of an elderly female with a giant vesical calculus weighing 1.28 kg (12.5 cm in diameter). Our patient had no past surgical history or symptoms suggestive of bladder outlet obstruction or neurogenic bladder. As per our literature search, a stone as large as that of our patient has not yet been found in females. She underwent an uneventful open suprapubic cystolithotomy. A biopsy from a suspicious lesion during the surgery revealed squamous cell carcinoma. Given that such a large stone was found in an elderly female without any predisposing causative factors, it is worthwhile looking into the etiopathogenesis and management of giant vesical calculi. [ABSTRACT FROM AUTHOR]

Synovial sarcomas constitute 5-10% of all soft-tissue sarcomas and tend to occur in the extremities, particularly the lower extremity. Renal sarcoma is a rare entity, constituting approximately 1-5% of all malignant renal tumours. Metastatic large renal synovial sarcoma with Inferior Vena Cava (IVC) thrombus is a rare surgical challenge that demands thorough preoperative evaluation and planning for its management. A 31-year-old young male presented with symptoms of left flank pain for 10 days, with a past history of similar complaints two years prior. On examination, a massively large renal mass was palpable. A Computed Tomography (CT) scan showed an IVC thrombus and metastatic deposits. The patient underwent a radical nephrectomy with ileal segment resection, followed by chemotherapy, which showed near-complete resolution of the metastatic deposits. Renal synovial sarcoma should be considered as a differential diagnosis in young patients presenting with a metastatic, exceptionally large renal mass complicated by an IVC thrombus, necessitating thorough preoperative evaluation for effective management. [ABSTRACT FROM AUTHOR]

Crossed fused ectopic kidney is a rare congenital anomaly wherein the kidneys are present on the same side due to fusion. It is a rare disease that may remain undiagnosed throughout life. Its rarity and anatomical abnormality make any intervention challenging. A 32-year-old male patient presented with symptoms of pain in the abdomen and burning micturition for a year. Serum creatinine, along with other blood tests, was normal. X-ray KUB showed renal calculi in the region of the right kidney. However, a Computed Tomography (CT) scan showed that the left kidney was malrotated and fused with the lower pole of the right kidney, suggestive of crossed fused renal ectopia. A cystoscopy and retrograde pyelography were performed, followed by open pyelolithotomy, wherein calculi were removed, and a stent was placed. Through this case report, it is suggested that adequate presurgery evaluation is necessary for patients with such malformations. [ABSTRACT FROM AUTHOR]

Background: Spontaneous renal hemorrhage is relatively uncommon but may be life- threatening. There are some challenges in early diagnosis due to the lack of specific presentations Case: We reported a case of A 45-year-old female presented with chief complaints of pain in right flank for 2 days. The pain was sudden in onset, severe, progressive and relieved by taking analgesics. On examination, vitals were stable. Tenderness and guarding were present in right renal angle with rest of the abdomen normal. Patient was shifted to ICU for observation and started on antibiotics, analgesics and antacids. USG Abdomen, CT Renal Angiography, MRI Abdomen were done. Diagnosis of perinephric haematoma was made. Patient was managed conservatively with close observation in view of normal vitals and was discharged in a stable condition after 12 days of uneventful stay in the hospital. She followed up twice in the OPD in a stable condition. Conclusion: We believe conservative management should be tried in cases where aetiology is not clear, failure of which should follow surgical intervention in the form of evacuation of haemorrhage. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the use of C-reactive protein (CRP) in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics. Patients and Methods: This is a prospective study that included patients diagnosed with bronchiolitis admitted to a tertiary care medical centre during the study period. A tracheal aspirate culture was taken from all patients with bronchiolitis. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level Results: Fifty patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level =2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection Conclusion: Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy. [ABSTRACT FROM AUTHOR]