scholarly journals Evaluation of medical treatment in Iranian children with nephrolithiasis

2021 ◽  
Vol 11 (1) ◽  
pp. e9-e9
Author(s):  
Ehsan Valavi ◽  
Azar Nickavar ◽  
Kamran Shehni Nejadpour ◽  
Elmira Esmizadeh
Keyword(s):  
Medical Treatment ◽  
Renal Stone ◽  
Renal Stones ◽  
Metabolic Abnormality ◽  
Pharmacologic Treatment ◽  
Common Causes ◽  
Urine Alkalinization ◽  
One Year ◽  
Iranian Children ◽  
Surgical Treatments

Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Medical Group ◽  
Consensus Definition ◽  
Transcutaneous Oxygen ◽  
European Consensus ◽  
Group A ◽  
One Year ◽  
Group B

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).

Study on Causes of Female Infertility at National Ayurveda Teaching Hospital, Borella, Sri Lanka: A Survey Based Study

2017 ◽  
Vol 3 (1) ◽  
pp. 249-252
Author(s):  
Farzana MUZN ◽  
Arshiya Sultana
Keyword(s):  
Sri Lanka ◽  
Teaching Hospital ◽  
Married Women ◽  
Female Infertility ◽  
Policy Makers ◽  
Complex Disorder ◽  
Anovulatory Cycle ◽  
Common Causes ◽  
Increasing Trend ◽  
One Year

Background: Infertility is defined as the inability to conceive after at least one year of unprotected intercourse. It is a complex disorder with significant medical, psychosocial, and economic problems. In about one third of couples are infertile. Approximately 167 million married women aged 15-49 years in developing countries were infertility. The present study aimed to determine the most common causes of female infertility in patients who visiting the National Ayuvedic Teaching Hospital, Borella, Sri Lanka. Methods: In this study 635 infertile (primary and secondary) women were selected to determine the causes of infertility. The subjects were selected from the gynecology clinic, between the periods of February 2015 to March 2016. The data were gathered using a questionnaire; and after that proper statistical method was applied to analyze the data. Results: From the results age between 28-37 years (37.16%) are more prevalent to infertility and the causes of infertility are mainly due to anovulatory cycle (31.18%) and menstrual irregularities (19.21%). BMI also one of the significant cause for infertility. Conclusion: Therefore, identifying the risk factors and proper treatment on time along with policy makers providing facilities to resolve the infertility could possible diverse this alarming increasing trend of infertility.

Comparative Study between Endoscopic Aided Septoplasty with Two Handed Technique using Endoholder and Conventional Septoplasty

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Apar Pokharel ◽  
Naganawalachullu Jaya Prakash Mayya ◽  
Nabin Gautam
Keyword(s):  
Comparative Study ◽  
Nasal Septum ◽  
Deviated Nasal Septum ◽  
Endoscopic Septoplasty ◽  
Septal Surgery ◽  
Significant Difference ◽  
Common Causes ◽  
Prospective Comparative Study ◽  
Evolutionary Step ◽  
One Year

Introduction: Deviated nasal septum is one of the most common causes for the nasal obstruction. The objective of this study is to compare the surgical outcomes in patients undergoing conventional septoplasty and endoscopic septoplasty in the management of deviated nasal septum. Methods:  Prospective comparative study was conducted on 60 patients who presented to the Department of ENT, College of Medical sciences, during a period of one year. The severity of the symptoms was subjectively assessed using NOSE score and objectively assessed using modified Gertner plate. Results: There was significant improvement in functional outcome like NOSE Score and area over the Gertner plate among patients who underwent endoscopic septoplasty. Significant difference in incidence of post-operative nasal synechae and haemorrhage was seen in conventional group compared to endoscopic group. Conclusions: Endoscopic surgery is an evolutionary step towards solving the problems related to deviated nasal septum. It is safe, effective and conservative, alternative to conventional septal surgery.

Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study

2020 ◽  
Vol 14 (2) ◽  
pp. 59-63
Author(s):  
Athar Hameed ◽  
Khazir Hayyat Gondal
Keyword(s):  
Shock Waves ◽  
Renal Stone ◽  
Plain Film ◽  
Renal Stones ◽  
Renal Calculus ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Fisher Exact Test

Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings. Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test. Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent. Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

scholarly journals Epidemiological determinants of infant deaths occurring in a teaching hospital: an observational study

2019 ◽  
Vol 6 (3) ◽  
pp. 1192
Author(s):  
M. N. Soumyashree ◽  
R. G. Viveki ◽  
Sunanda Halki
Keyword(s):  
Birth Asphyxia ◽  
Medical Sciences ◽  
Place Of Delivery ◽  
Demographic Profile ◽  
Infant Deaths ◽  
Live Births ◽  
Mother And Child Health ◽  
Common Causes ◽  
Mother And Child ◽  
One Year

Background: India has the highest number of infant deaths, contributing about 23% to the global burden of infant deaths. Sustainable development goal states that, by 2030, preventable deaths of new-borns and children under 5 years of age should be ended, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births. Aims of the study: (1) to understand the socio-demographic profile of the study cases, (2) to correlate the causes of infant deaths with age, parity and other obstetrics parameters.Methods: The present study was undertaken for the period of one year from January to December 2016. The study included 120 deceased infants from department of Pediatrics, Belagavi Institute of Medical Sciences (BIMS) Hospital, Belagavi. Information regarding socio-demographic profile, antenatal, intranatal and infant details were collected using a structured questionnaire.Results: 61.6% of study cases were male and three-fourth of them resided in rural area. 56.2% of the deceased infants were LBW, followed by VLBW (34.9%) and ELBW (8.9%).  The common causes of death among the deceased infants were prematurity (45%) followed by, birth asphyxia (34.2%), sepsis (12.5%), pneumonia (3.3%) and congenital anomalies and other (2.5%).Conclusions: Age of the infants, gestational age, place of delivery, delivery assisted and LBW were associated with infant deaths. There is a need for proper implementation of programmes related to mother and child health care.

scholarly journals Renal stones

2018 ◽  
Vol 56 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Adie Viljoen ◽  
Rabia Chaudhry ◽  
John Bycroft
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Renal Stone ◽  
Surgical Intervention ◽  
Recurrent Disease ◽  
Renal Stones ◽  
Evidence Base ◽  
Stone Disease ◽  
Significant Morbidity ◽  
Renal Stone Disease

Renal stone disease is a worldwide problem which carries significant morbidity. It frequently requires specialist urology intervention. Patients with recurrent disease and those at high risk require specialist investigations and review. Certain cases benefit from medical and surgical intervention. In this review, we discuss the pathophysiology, risk assessment, specialist investigations and various interventions, their rationale and evidence base. This review aims to provide an update of the previous publication in 2001 in this journal on this topic.

scholarly journals Effects of Referral to a Specialist for Headache

1983 ◽  
Vol 76 (2) ◽  
pp. 112-115 ◽  
Author(s):  
Ray M Fitzpatrick ◽  
Anthony P Hopkins
Keyword(s):  
General Practitioner ◽  
Medical Treatment ◽  
Placebo Response ◽  
Considerable Improvement ◽  
Outpatient Clinics ◽  
Structural Lesion ◽  
One Year

Patients consulting neurological outpatient clinics for headaches that were found not to be due to a serious structural lesion were followed up one year afterwards. Considerable improvement in symptoms was found in the sample. This was only partly attributable to any medical treatment received at the clinics or subsecquently from a general practitioner. Improvement was associated with previously expressed satisfaction with the clinic consultation, and a nonspecific ‘placebo’ response is postulated.

High Incidence of Renal Stones in Severely Disabled Children with Epilepsy Treated with Topiramate

2019 ◽  
Vol 50 (03) ◽  
pp. 160-163 ◽  
Author(s):  
Nobutsune Ishikawa ◽  
Hiroo Tani ◽  
Yoshiyuki Kobayashi ◽  
Akira Kato ◽  
Masao Kobayashi
Keyword(s):  
Medical Records ◽  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Treated Group ◽  
Urinary Stones ◽  
Disabled Children ◽  
High Incidence ◽  
Diuretic Drugs ◽  
History Of

Purpose This study was aimed to assess the accurate incidence of renal stones in severely disabled children treated with topiramate (TPM). Method We reviewed the medical records of severely disabled children with epilepsy under 15 years old who underwent radiological examinations to investigate urinary stones. The study enrolled 26 patients who were divided into two groups. One group had been treated with TPM for at least 1 year and the other had not been treated with TPM, zonisamide, acetazolamide, or other diuretic drugs. We collected parameters from the medical records and compared the groups. Results All participants were evaluated radiologically, with computed tomography (CT) in two patients, ultrasonography in 22 patients, and both in two. No patient had any morphological abnormality of the kidneys and history of urinary tract infection. There were no significant differences in sex, age, body weight, or feeding manner between the groups, while the incidence of renal stones or calcifications was significantly higher in the TPM-treated group (60 vs. 0%; p = 0.00241). Conclusion There is a high incidence of renal stone formation in severely disabled children treated with TPM.

scholarly journals Renal stone disease: causes, evaluation and medical treatment

2006 ◽  
Vol 50 (4) ◽  
pp. 823-831 ◽  
Author(s):  
Ita Pfeferman Heilberg ◽  
Nestor Schor
Keyword(s):  
Medical Treatment ◽  
Renal Stone ◽  
Salt Intake ◽  
Current Knowledge ◽  
Stone Formation ◽  
Potassium Citrate ◽  
Blood Analysis ◽  
Dietary Recommendations ◽  
Metabolic Disturbances ◽  
Mineral Density

The purpose of the present review is to provide an update about the most common risk factors or medical conditions associated with renal stone formation, the current methods available for metabolic investigation, dietary recommendations and medical treatment. Laboratory investigation of hypercalciuria, hyperuricosuria, hyperoxaluria, cystinuria, hypocitraturia, renal tubular acidosis, urinary tract infection and reduction of urinary volume is based on the results of 24-hr urine collection and a spot urine for urinary sediment, culture and pH. Blood analysis for creatinine, calcium and uric acid must be obtained. Bone mineral density has to be determined mainly among hypercalciurics and primary hyperparathyroidism has to be ruled out. Current knowledge does not support calcium restriction recommendation because it can lead to secondary hyperoxaluria and bone demineralization. Reduction of animal protein and salt intake, higher fluid intake and potassium consumption should be implemented. Medical treatments involve the use of thiazides, allopurinol, potassium citrate or other drugs according to the metabolic disturbances. The correction of those metabolic abnormalities is the basic tool for prevention or reduction of recurrent stone formation.

Sign in / Sign up

Export Citation Format

Share Document