An Ayurvedic Management of Cholelithiasis- A Case Report

Background: There are several diseases which arise in gall bladder and one of them is gall stones (cholelithiasis). The prevalence rate is difficult to work out because calculous disease is often asymptomatic. Cholelithiasis has become one among the foremost common diseases of the biliary tract. approximately 80 percent of gallstones contain cholesterol and therefore the remaining 20 percent are pigment stones, which consist mainly of calcium bilirubinate. Case Report: A 35-year male patient approached complaints of heaviness of abdomen, mild intermittent abdomen pain, nausea and with ultrasonography report which was suggestive of cholelithiasis of 4.7mm. Conclusion: The patient was diagnosed as Pittashmari and treated with ayurvedic medicine. With the help of Ayurvedic treatment protocol, the patient was free from 4.7mm cholelithiasis within 2 months of treatment and also improvement was observed in symptoms like the heaviness of the abdomen, pain in the abdomen, and nausea.

Calcium bilirubinate sludge causes early onset of congenital biliary dilatation: a report of two cases

Background Symptomatic congenital biliary dilatation (CBD) during early infancy is always characterized by cystic dilation of the common bile duct with a narrow segment connecting the pancreatic duct. Case presentation In two consecutive infants with a prenatal diagnosis of CBD, we found that biliary sludge had formed in the cyst upon the appearance of symptoms including acholic stool and hypertransaminasemia. Infrared absorption spectrometry revealed that the sludge consisted of calcium bilirubinate. Conclusion We suggest that overproduction of bilirubin by neonatal hemolysis causes sedimentation of bilirubin calcium, resulting in obstruction of the narrow segment and development of symptoms.

Etiology and chemical composition of gall stone disease: a prospective observational study from the developing world

Background: Aim of the study was to assess the etiology and determine the chemical composition of gallstones in our population.Methods: This was a prospective observational study conducted at GMC Srinagar from 2018 to 2020. One hundred patients having gall stone disease were enrolled into the study and after cholecystectomy was performed the stones chemical composition was analyzed by fourier-transform infrared (FTIR) spectroscopy. The data was collated and analysed.Results: 54 patients had mixed stones with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate; 39 had cholesterol stones and 7 patients had pigmented stone with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate.Conclusions: Our results suggest that cholesterol, either singularly or in combination with calcium carbonate or bilirubin is a common component of gall stones in our population.

Infrared spectroscopy in kidney and biliary stone disease

Nephrolithiasis is a complex, multifactorial disease resulting from an interaction between environmental and genetic factors. A minority of patients form stones because of well defined systemic diseases. In the rest, who usually are otherwise well expected for stone formation, the pathogenesis of stone is not as cleary defined. Compressive metabolic evaluation has become an important aspect of the management of recurrent nephrolithiasis, yet the role of stone analysis is often neglected or perhaps underestimated. The purpose of this study is to evaluate the chemical composition of kidney and biliary stones in our patients in order to provide guidance in metabolic evaluation and medical diagnosis, therapeutic treatment and prevention of recurrence. We used infrared spectroscopic method (Perkin Elmer Infrared Spectroscopy) to analyze the chemical composition of 224 kidney stones passed spontaneously or removed surgically and 40 gallstones removed surgically in the ?Mother Teresa? University Hospital Centre of Tirana. Of 224 kidney stones 62 % belong to male and 38% to female patients. Of infrared spectroscopic examinations of kidney stones 75.4% of results are calcium oxalate (CaOx) stones, 12.5% uric acid (UA) stones, 10.3% phosphate stones and 1.8% cystine stones. Of CaOx stones 67.4% are pure CaOx stones and 32.6% are mixed composition stones (CaOx mixed with UA or apatite). Of UA stones 82.1% are pure UA stones, 10.7% are UA stones mixed with ammonium urate and 7.2% are pure ammonium urate stones. Of phosphate stones 39.1% are of struvite composition, 26.1% are of carabapatite composition and 34.8% are of struvite composition mixed with apatite. The incidence of CaOx stones, UA stones and cystine stones is higher in men, while phosphate stones predominate in women. The chemical composition of 40 biliary stones examined with infrared spectroscopy is the following: 2.5% are pure calcium bilirubinate stones, are 42.5% are pure cholesterol stones and 55% are mixed stones (cholesterol stones mixed with calcium bilirubinate, calcite, aragonite or apatite). Females predominate in bilary stones. Calcium stones are the most frequent kidney stones. Calcium stones, uric acid stones and cystine stones were found more frequently in males than in females. On the other hand, phosphate containing stones, very often called ?infection stones?, were more frequent in female patients. Cholesterol stones predominate in gallstones examined by infrared spectroscopy. All types of gallstones are more frequent in women than in men. Stone analysis alone may provide guidance for therapeutic treatment and recurrence prevention.