Effect of α-adrenergic blockers silodosin in the management of distal ureteric calculus

Background: Urinary calculus disease is one of the 3 most common urological diseases. It affects about 12% of the world population and has become a worldwide health problem. Of all the urinary tract stones 20% are ureteral stones, of which 70% are found in the distal ureter. The objective of the study is to study the effect of silodosin in the passage of calculi in the distal ureter compared to non-steroidal anti-inflammatory drugs (NSAIDs) (diclofenac sodium) and oral fluids.Methods: This study included a total of 90 patients between the study period from October 2016 to October 2018. 45 patients were chosen randomly and advised to take plenty of oral fluids and treated with NSAIDs and the other 45 patients were treated with silodosin 8 mg HS for one month along with oral fluids and NSAIDs. After 1 month if the stone was passed successfully, it was confirmed with ultrasonography, if failed, advised for surgery.Results: Majority of the patients were in the age group of 20-45 yrs. The mean size of the calculus was 5.60 cm on the right side and 5.71 cm on the left side. Out of the 45 patients who were on treatment with silodosin 35 patients had passed the calculi and 10 patients had no results with a success rate of 77.7%. In the 45 patients who were not on silodosin, 8 patients passed the calculi and 37 patients did not pass the calculi. 21 patients among the 45 underwent urethrorenoscopy.Conclusions: Silodosin is an effective and safe drug in the management of calculi in the distal ureter.

Diagnosis of Helicobacter pylori in cholelithiasis and cholecystitis: by histology and serological association

Background: Biliary calculus disease is one of the most common disorders affecting the gastrointestinal tract. It is an important cause of morbidity. There has been marked rise in the incidence of gall stone disease in the west. In India, it is more common in northern states than in South India. Incidence of gallstones increases with age with a male to female ratio of 1:4. About 50% of these patients are asymptomatic.Methods: An analytical prospective study on patients diagnosed with cholecystitis and/or cholelithiasis was conducted in R. L. Jalappa Hospital Tamaka, Kolar. 58 patients were included in the study between June 2018 and May 2019. Data was collected and analysed using SPSS 22 version software. Categorical data was represented in the form of frequencies and proportions.Results: The age incidence was found to be highest between 31 to 40 years. The incidence of cholelithiasis was more in females. All patients presented with pain abdomen. Calculous cholecystitis was the most common mode of presentation. Open cholecystectomy was commonly done for cholelithiasis in our set up. Chronic calculous cholecystitis is the commonest histopathology.Conclusions: According to our findings evidence of recent and chronic infection Helicobacter pylori as shown by demonstration of IgM and IgG class of antibodies respectively to the organism was found in most of patients and histological evidence of the patients with cholecystitis and cholelithiasis. Thus, the frequency of helicobacter infection seems to be low in the patient population studied.

A study of etiology and role of bacteria in the pigment gall stone diseases at a tertiary care hospital

Background: Calculus disease of the biliary tract continues to be a significant health problem. Pigment stones are more common in Eastern studies. Predisposing factors such as cirrhosis, ileal resection are commonly seen in the West; while infection as a cause predominates in South East Asia. In this study we prospectively studied Pigment gall stones to examine the causes for and the role of bacteria in pigment Gall stone diseaseMethods: A hospital based prospective study was carried out from January 1992 to December 1994 at Nizam’s Institute of Medical Sciences, Hyderabad. Institutional Ethics Committee permission was taken. Informed consent was obtained from all selected patients. During the study period a total of 25 consecutive patients with Pigment gall stones were analyzed. Details were recorded in a proforma. Stones were collected from the Gall Bladder with aseptic precautions.Results: Total of 25 patients included, wherein 13 (52%) males and 12 (48%) females. The Median age was 55.5 years and the mean age was 50.2 years. Of 25 patients 11 (44%) had black pigment stones and 14 (56%) had brown stones. 22 (88%) patients presented with biliary colic, and 8 (32%) presented with chronic cholecystitis. At surgery 14 (56%) had a thickened wall suggesting inflammation, 7 (28%) had edema. Bile culture was positive in 11 (44%) patients and stone culture in 5 (20%) patient. Twenty two of 25 patients (88%) had evidence of bacteria on electron microscopy.Conclusions: Whether black stones are associated with higher infection rates or bacteria cause black stones – this question probably would never be answered either on the bench or in the clinicians ward. We, however, can definitely say they are intimately related.

PREVALENCE OF RENAL CALCULI;

Renal calculus is a hard mass. It is formed from the crystals that aggregate onthe inner surfaces of the kidney. Small crystals flow to the urinary tract and pass out of the bodyspontaneously along with urine without being noticed. Objectives: The purpose of the presentstudy is to find the type; age and gender related prevalence of the renal calculus disease inSouthern Punjab Pakistan. Study design: The study design is retrospective. Period: Two yearfrom June 2009 to June 2011. Materials and Methods: In this work, 1176 samples of renalcalculi from both male and female patients of the southern Punjab, Pakistan, were collected.Semiquantitative analysis of the renal calculi was carried out using Merckogonost Reagent Kit.Results: Highest prevalence of the renal calculus disease was in the age group 40-49 in malesand in the age group 30-39 in females. The disease was more common in males than females.Calcium oxalate was the predominant renal stone.