Patternof Urinary Calculi ata Tertiary Hospital inSubsaharanAfrica (original) (raw)
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Epidemiology and chemical composition of upper urinary tract calculi
Urolithiasis is a worldwide problem, but the incidence differs depending upon geographical location, race, heredity, climate, congenital anomalies of urinary organs, inborn errors of metabolism, age, sex, etc. in India the incidence of urolithiasis is higher in northern states compared to that in southern states. The aim and objectives of the study were to evaluate the patient with upper urinary tract stones in terms of incidence, clinical presentation, age and sex distribution and tostudy various predisposing factors and chemical composition of upper urinary tract stones. The material for the clinical study of upper urinary tract stones was taken from the cases admitted to Department of General Surgery; Shimoga Institute of Medical Sciences, Shimoga in the period of April 2014 to March 2015. As a routine for the cases of upper urinary tract stones, the patients are subjected to physical examination, routine investigations and ultrasonography of the abdomen. The patients are then subjected to either forced diuresis or surgical procedures like pyelolithotomy or ureterolitholomy or nephrectomy depending upon the size and location of the calculus and extent of renal damage. The stones recovered are then subjected to chemical analysis. In the above mentioned period a total of 29 cases were evaluated and details of these cases were collected from medical records from the MRD, SIMS. The incidence of upper urinary tract stones in our study was 11 per 10,000 hospital admissions. The maximum incidence was observed in the third and forth decades. The overall male to female ratio is 3.8:1. The incidence of upper urinary tract stone appeared to be high in rural population. Nearly 60% of patients consumed hard water and 75% of patients were non vegetarians. The commonest mode of presentation was loin pain (96.5%). Urinary tract infection was present in 41% of patients and commonest organism being E.coli. In stone analysis it was found that all the stones except one were mixed stones. Calcium (96.5%), phosphate (96.5%) and oxalate (86.2%) were the predominant radicals. One case of pure uric acid calculus was found. The incidence, clinical presentation, age and sex distribution found in this study compares fairly with other Indian series conducted earlier. Comparatively high incidence of urinary calculi in the agriculturists and manual workers reflects the environmental influence of high temperature found in this part of our study. Similarly a higher incidence is noted in rural population who consume mainly ground water which is usually hard in nature. Finally the chemical composition of stones found in this series of study is in concurrence with earlier Indian and western series with calcium, phosphate and oxalate being predominant radicals.
Objectives: The present study was conducted to evaluate the prevalence of urolithiasis in relation to patients six, age, and anatomical distribution of stones and to assess the chemical composition of urinary stones qualitatively to identify common type of urinary stone which prevalence in Nasiriyah city and how can provide the recurrence of stone formation if possible. Methods: Forty-four calculi obtained from 29 males and 15 females afflicted with Urolithiasis and admitted at Al Hussein Teaching Hospital, Thi-Qar governorate, Nasiriyah city, Iraq, from July 2010 to September 2011. Their ages ranged from 30 to 60 year. All samples analyzed qualitatively for ammonia, magnesium, phosphate, magnesium ammonium phosphate, carbonate, calcium salts (oxalate and non-oxalate), uric acid, xanthine, and cystine by adopting standard methods. Results: The study results showed that, the prevalence of stones was more in males (65.91%) than females (34.09%) with male to female ratio of 1.93:1 and the high occurrence in patients aged from 30 to 50 years. The anatomical distribution of urinary stones showed high percent in kidneys 52.27 % (23 patients) and bladder 47.73 % (21 patients), but it is absent in ureters and urethral (0.00 %). All the stones were of mixed type, of these stones contained 42 (95.46 %) calcium salts (oxalate and non oxalate), uric acid, and ammonium ion, 41(93.18 %) phosphate, 33 (75.00%) magnesium and magnesium ammonium phosphate (MAP), 29 (65.91%) carbonate, 26 (50.00) xanthine, and 7 (15.91 %) cystine. In addition, there are no differences in the chemical combustion between kidneys and bladder stones. Conclusion: Urolithiasis in Nasiriyah is a problem with high frequency in men than women and usually described as more frequent in age ranged 30 to 50 year and in kidneys and bladder than ureters and urethral. The majority of urinary stones types had a mixed type in which calcium salts (oxalate and non-oxalate), uric acid, ammonia phosphate and struvite were the predominant constituents related that both the metabolic disturbances and bacterial infection causes, which have the same majority and effect in the stone formation.
Chemical analysis of stones and its significance in urolithiasis
The search of literature showed Urolithiasis as a multifactorial recurrent disease, distributed worldwide in urban, rural , non industrial and industrial regions with different chemical composition of analyzed stones in context to various etiological and risk factors. The present study was aimed to qualitatively analyze the uroliths obtained by surgical intervention at Krishna hospital Karad, a South West region in Maharashtra (India), to evaluate the predominant constituent present in them and report its significance. The study reported, urolithiasis was more suffered by individuals between the age group of 30 to 60 years with more predominance in males than females. The chemical analysis of uroliths showed that all the assessed stones were of mixed heterogeneous type, Magnesium Ammonium Phosphate (71.2%) was predominant constituent followed by Calcium Oxalate (68.8%), Calcium Carbonate (64.0%), Urate (44.8%), Cystine (12.8%), Xanthine (2.4%) and Fibrin (1.6%). The study concludes simple qualitative laboratory based method for assessing chemical composition of various uroliths allowed a reliable diagnosis of stone contents whose data may be useful in advising the people of this region for taking preventive measures for reducing the risk of prevalence and recurrence of urolithiasis in them.
Chemical Study of Urinary Calculi
Journal of Ayub Medical College Abbottabad, 1989
Of the 120 stones analysed, 54 were renal in origin, 52 were bladder stones, 2 were ureteric stones while 12 were spontaneously passed.92% (111) stones contained calcium oxalate as the main component. Of these 922%, 58.3% (70) stones were pure calcium oxalate. The male to female ratio was approximately 6:1. Peak presentation was in the 15-45 years' age group.
Chemical Composition of Urinary Calculi from Al-Jouf Province of Saudi Arabia
2007
Objective: Saudi Arabia has a high incidence of urolithiasis. This study was undertaken to understand the composition and location of the stones from patients living in the province of Al-Jouf of Saudi Arabia. Methods: Fifty-eight renal calculi from Al-Jouf area of Saudi Arabia were analyzed by semiquantitative titrimetric and colorimetric methods. Results: The urinary stones were mainly localized in the bladder (36.3%) followed by the kidneys (27.6%) and were more frequent in males (88%). The result of the analysis shows that the calculi belong to oxalate (84.5%), calcium (65.5%), magnesium (58.6%), urate (36.2%), phosphate (27.6%), carbonate (13.8%), ammonium (6.9%) and cystine (1.7%). The most frequent chemical constituent was calcium oxalate (48.3%) followed by ammonium urate (22.4%), calcium phosphate (15.5%) and magnesium phosphate (13.8%) and pure form of uric acid (13.8%). Oxalate containing stones were more frequent in males than in females while phosphates containing ones were less frequent in males than in females. Conclusion: The findings of the present work indicate that urolithiasis in the province of Al-Jouf represent common urological problem and is correlated with the nutritional, environmental and genetic factors.
International Surgery Journal
Background: The aim of the study was to evaluate the chemical composition of urinary stones and pattern of changes according to the patient's demographic and geographical distribution.Methods: 150 patients of upper tract urolithiasis were prospectively selected during the study period. Chemical composition was analyzed by FTIR spectroscopy. A subgroup study based on the patient's age, sex and geographical origin was done. For subgroup analysis patients were divided into two age groups; group A (5-18 years, 14 patients) and group B (>18 years, 136 patients). The geographical origin of the patients was recorded according to the administrative division.Results: Male were predominant in all age groups with ratio of 2.49:1. Most of the patients were from Rangpur (28.67%) and Mymensingh (20.67) division. Mixed composition stones were much more common than pure one (75.99% vs 24.01%). Overall, combination of calcium oxalate monohydrate with dehydrate was the most common composit...
Composition of urinary calculi in infants: a report from an endemic country
Urolithiasis, 2017
Pediatric urolithiasis remains endemic in low-resource countries where infants constitute 17-40% of all children with urolithiasis. This study reports socio-economic factors, medical history and chemical composition of urinary stones in 976 infants of up to 2 years of age. Between 1992 and 2016, 976 infants presented to our institute with 1038 stones. Chemical composition of stones was analyzed by Fourier transformation infrared spectroscopy (FTIR). The mean age of infants was 19.5 ± 5.74 months with a M:F ratio of 5.5:1. Half (50%) of the infants were rural dwellers, 90% belonged to low socio-economic class and 70% were malnourished. A history of chronic diarrhoea was reported in 13% and urinary tract infections in 5%. The anatomic location was bladder in 487 (46.9%), kidney in 246 (23.6%), ureter in 142 (13.6%), urethra in 2 (0.2%) and 161 (15.5%) were passed spontaneously. Overall frequency of compounds in stones showed ammonium acid urate (AAU) in 772 (74.37%), calcium oxalate (...
Chemical Composition of Urinary Stones in Patients with Urolithiasis in Sana’a, Yemen
This study was aimed to identify of chemical composition of kidney stones of patient in Sana’a, Yemen because the lack of research done in this field. The study was integrated within the clinical practice. Patients, mothers or child's guardian received a simple explanation for the aim of the study as an ethical issue. 581 samples of chemical compositions were collected andanalyzed in the National Center for Public Health Laboratories Sana'a, Yemen according to qualitative method. The results showedthat 54.6 % of the calcium oxalate, 6.3 % of the uric acid, 0.7 % of the calcium phosphate, 29.6 % of the calcium oxalate and uric acid, 6.7 of the calcium oxalate and calcium phosphate, 1 % calcium oxalate and calcium carbonate, 0.5 % of the calcium oxalate, calcium phosphate and uric acid, 0.5 % of the calcium oxalate, calcium carbonate and uric acid, and 0.2 % calcium phosphate and uric acid. In conclusion, calcium oxalate was the most predominant chemical compositions in stones and it represents common urological problem in Sana’a, Yemen.
Update analytic program for laboratory investigation in urinary tract calculosis
Jugoslovenska medicinska biohemija, 2004
Urinary tract calculosis due to it's high recurrence rate (50-100% in untreated patients) and possibility to cause chronic renal failure in 20% still represents a great social and medical problem. From that aspect, an adequate clinical evaluation in stone forming patients is of paramount importance. An effective and rational attitude in detecting possible causes of stone formation demands the adequate analytic program in biochemical investigations. Presented program is adjusted to the guidelines on urolithiasis, recommended by Board EAU (European Association of Urologists) Healthcare Office, for year 2003. Regarding to known chemical stone composition, category of stone former and presence of an specific risk factor, analytic program could be minimal (fasting morning spot urine sample analysis, urineculture and blood analysis (calcium, albumine, creatinine and urate and stone analysis) and extended (quantification of all parameters in serum and in two consequtive 24h urine colle...
Objective: The purpose of this study was to perform the chemical analysis of stones to know the pattern of biochemical composition of stones in Sudanese subjects. Methods: 169 renal stones were analyzed during the period from February to December 2008. 96 patients were referred to Gezira Hospital for Renal diseases and Surgery (GHRDS), Gezira state, central Sudan. The stones were analyzed by semi quantitative method in the Gezira central laboratory. Kits were used for chemical analysis of stones. Calcium, phosphate, oxalate, uric acid, carbonate and cystine were determined. Results: Male to female ratio was 2:1. Calcium, oxalate and uric acid were the most common forms of stones (90.5%), followed by phosphate (4.7%), carbonate (3.0%) and cystine which accounted for 1.8% of the study subjects. Conclusion: The relative frequency of calcium oxalate stones in our study about University Of Gezira