#ursl

[lanaliar]

METTATON - CORE LEADER AND CHIEF OF MAYORS

AU Undertale - URSL/Underramson.

[lanaliar]

In our Undertale AU URSL/Underramson, ghosts are also different. There are only 9 types, but I have drawn 6 so far. The blue one in the form of water is Napstablook, the pink one is Mettaton, the yellow one is the ghost of a mad dummy.

[lanaliar]

New locations and their mayors have been added to my undertale AU. You can see two of them in the art. Below is also a sketch.

Actually, I even have a sketch from the Amber Gorge. I'll write about the locations below.

(By the way, you can notice a mad dummy on the art)

Locations:

Amber Gorge is a hidden location that was only found by the wealth ghosts. Now it is home to crystal salt bees, some dinosaurs, dragons, and other honey insects and living crystals. Monsterkid is a native inhabitant of the location, аnd also the ghost of mad Dummy.

The Ruby Kingdom is a red castle below Asgore's castle, home to oligarchs, the rich, and redstone miners.

The Plantarium is a location built on fertile soils and illuminated by bright green crystals that reflect light. It houses biological institutes, schools, hospitals, and nursing homes. Located west of Waterfall.

The Silkworm's Burrow is a deep cavern below the water line and home to arachnids, large beetles, and moths. It is where Muffet comes from.

[lanaliar]

[pace-hospitals]

Successful Bilateral URSL & DJ Stenting for Obstructive Ureteric Stones in a 29 Y.O. Male Relieving Ureteric Obstruction

The PACE Hospital's expert Urology team successfully performed Bilateral Ureteroscopic Lithotripsy (URSL) with DJ stenting on a 29-year-old male patient who presented with left flank pain. The procedure was performed to remove ureteral stones, relieve obstruction, and restore normal urinary flow.

PACE Hospitals is one of the Best Urology Hospital in Hyderabad, India, providing holistic and patient centric urological treatment. The team of experienced and skilled urologists, urology surgeon has vast expertise in managing all kind of critical urology disease and disorder, including:

Urinary tract infections (UTIs)

Urinary incontinence & retention

Urinary bladder disease

Kidney stone diseases

Bladder, Kidney and Prostate cancer 

Hydronephrosis

Benign prostatic hyperplasia (BPH)

Ureteral stones­

Kidney transplantation

☑️ Chief Complaints

A 29-year-old male patient with a body mass index (BMI) of 22 presented to the Urology Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of left flank pain. A comprehensive evaluation was undertaken to identify the underlying cause of his symptoms.

☑️ Past Medical History

The patient had a history of open-heart surgery for a patent foramen ovale (a hole between the heart's upper chambers that remains open after birth) at the age of 7 years. No known drug allergies were reported.

☑️ Examination

Upon admission, the patient was conscious, alert, and oriented. He was afebrile, and his vital signs were stable. Physical examination revealed mild tenderness on deep palpation of the left flank, correlating with the patient's symptoms. No abdominal masses were palpable, and there were no signs of peritonitis such as guarding, rebound tenderness, or rigidity. Cardiovascular and respiratory system examinations were within normal limits.

☑️ Diagnosis

Upon admission to PACE Hospitals, the patient was thoroughly evaluated by the Urology team, including a detailed review of his medical history and a comprehensive clinical examination. Presenting with left flank pain and a history of recurrent stones, there was a strong clinical suspicion of urinary tract obstruction caused by calculi.

The patient underwent imaging studies, including a non-contrast CT scan of the kidneys, ureters, and bladder (CT KUB), which revealed bilateral mid-ureteric calculi measuring approximately 7 mm on both sides, resulting in mild hydroureteronephrosis more pronounced on the left side. Additionally, multiple small non-obstructing renal calculi were noted bilaterally. Laboratory investigations showed normal renal function and no evidence of active infection.

☑️ Surgical Procedure

Following the decision, the patient was scheduled for Bilateral Ureteroscopic Lithotripsy (URSL) and DJ stenting surgery in Hyderabad at PACE Hospitals, under the expert care of the urology department.

The procedure involved the following steps:

Patient Preparation and Anesthesia: The patient was positioned in the lithotomy posture and general anesthesia was administered. The surgical site was sterilized, and prophylactic antibiotics were given to prevent infection before starting the procedure.

Ureteroscopic Access and Assessment: A semi-rigid ureteroscope was introduced through the urethra to visualize both ureters. The right ureteric stones were cleared easily, while an impacted stone with surrounding edema was found in the upper left ureter.

Laser Lithotripsy: The left ureteric calculus was fragmented using a low-energy laser, carefully to avoid ureteral injury. Stone fragments were removed or left to pass naturally to clear the obstruction.

Double J Stenting: A Double J stent was placed in the left ureter to ensure urine flow and prevent obstruction post-surgery. Placement was confirmed under imaging, and no ureteral injury was observed.

Procedure Completion and Recovery: The scope was withdrawn after confirming hemostasis. Stone fragments were sent for analysis, and the patient’s postoperative course was smooth. A follow-up was planned for stent removal after three months.

Absolutely! Here’s your content, adapted for “Successful Bilateral URSL & DJ Stenting for Obstructive Ureteric Stones in a 29 Y.O. Male Relieving Ureteric Obstruction,” in the same style:

🌟 Why PACE Hospitals?

PACE Hospitals — Best Hospital in Hyderabad, Telangana, India, stands out as a premier center for advanced urological procedures, including Bilateral URSL (Ureteroscopic Lithotripsy) & DJ Stenting for obstructive ureteric stones. Recently, the hospital successfully treated a 29-year-old male patient, relieving severe ureteric obstruction and restoring normal urinary flow. The hospital’s approach integrates:

✅ Advanced diagnostics for precise stone localization and assessment

✅ World-class urological surgical expertise in minimally invasive stone removal

✅ Comprehensive post-procedure care and monitoring

✅ Emotional and nutritional support for patients and their families

🔗 Read the full case study here: https://www.pacehospital.com/bilateral-ursl-dj-stenting-for-ureteric-stones-treatment-case-study

👉 Book an Appointment: Best Doctors in Hyderabad, Telangana, India 👉 Patient Testimonial: Patient has to say about their experience with us

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[gigidagia]

Amount - Panik unter Palmen (Lauer Remix) (2022)