Emphysematous pyelonephritis is a rare but life threatening infection of kidney that is characterized by gas formation within or around the kidney. We describe a case of emphysematous pyelonephritis as a consequence of inadequately treated pelvic-ureteric stone in a diabetic man and complement this with a brief review of the literature pertaining in particular to the management of this condition.
In today’s digital era, it is possible to use the latest technology to improve student attendance and performance. The purpose of the present study is to determine the relationship between absenteeism and academic performance among Calculus students, as well as to measure the impact of class absence on the student’s final exam scores. Based on this, the use of appropriate
strategy was employed, which is the mobile attendance application to reduce absenteeism among students in higher educational institution. The selection of sample was based on cluster sampling, involving the selection of 87 repeater students. The data collected were analyzed using quartile
regression and independent sample t-test. The result of the findings revealed that the class absence has an impact on the student’s final exam scores. This is because, if the student was absences by 1 class, the final exam score is expected to decrease on average by 1.89%. Hence, findings show that the percentage of absences for the students with manual attendance was higher
than the percentage of absences for the students with mobile attendance application. The application can help to reduce absenteeism by reminding students about recent attendance records.
Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968-May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V-Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed.
Ureteroscopy (URS) is commonly used by urologists to treat ureteral stones. It is a relatively low-risk procedure. Both urinary tract obstruction and contamination of instrument can cause candiduria post-URS, and this infection can be treated with an antifungal medication. Candidemia is known as hematogenous dissemination, and ocular tissue is a common invasion. However, endogenous endophthalmitis, due to postureteroscope candiduria, has not been reported up to date. This is a devastating complication that may lead to visual loss. Here, we describe a case of endogenous endophthalmitis as a consequence of candiduria after URS.
Sialolithiasis is the formation of calculi or sialoliths in the salivary gland. It is the most common benign condition of the salivary gland. Sialolithiasis can occur in all salivary glands. The submandibular gland is most commonly affected followed by the parotid gland. Calculi commonly measure less than 10 mm. Calculi of more than 15 mm are termed giant salivary gland calculi and are infrequently reported in the literature. Here, we report a case of unusually large submandibular gland calculus of 5 cm in greatest dimension which caused erosion of the oral cavity.
A 46-year gentleman presented with a left-sided lumbar region pain without fever or dysuria. He denied episodes of acute urinary retention. There was a hard mass at the distal urethra with normal laboratory blood tests. Computed tomography urogram revealed a concurrent left renal staghorn calculus and large distal urethral stone. The urethral stone was fragmented via endourologic technique successfully. We report a case of a non-obstructing large urethral calculus in a gentleman with concurrent left renal staghorn calculus and discuss the literature review.
Incidence of urolithiasis is on the rise due to climatic changes especially global warming.The pain due to presence of ureteric stone is a well known identity but many times it may be asymptomatic or even masked by concurrent presence of backache. In the present article, we describe the case of a 43-year-old male who came to the clinic for treatment of backache persisting for more than two years. The patient complained of backache two years back for which he was treated with analgesics and physiotherapy which relieved his pain. No X-ray was taken earlier because the attending clinician thought the backache to be musculo-skeletal in origin. Recently, one day a sudden episode of backache in the midst of night compelled him to seek medical treatment. However, this time a X-ray was performed and it showed the presence of calculi in the right upper pelvis of ureter which measured 1.9 cm vertically. An ultrasound confirmed the diagnosis. The patient was treated with two episodes of shock wave therapy which failed to crush the stone. A Double-J stent was inserted under general anaesthesia. The stone was crushed using a ureteroscope guided laser. The present case report describes how backache in professionals cannot be lightly attended. Even the characteristic groin to loin pain may be absent. All cases of backache should be properly investigated with an X-ray to rule out renal or ureteric calculi.
To determine the efficacy of a combination of simultaneous shock wave lithotripsy (SWL), hydration with controlled inversion therapy compared with SWL with hydration alone in patients with lower pole calyx stones.
Salivary duct obstruction secondary to calculi is a common disorder of the submandibular gland and often manifesting as painful episodic swelling of the gland during meals. Complications may arise in unresolved obstruction leading to infections, abscess formation and a hypofunctioning gland. Treatment of this disorder has evolved from the traditional sialadenectomy to organ preserving procedures done under general or local anaesthesia. Our technique using Ellman Surgitron radiofrequency device, is another alternative technique for transoral removal of extraglandular calculi. It is a simple, quick an easy technique to learn that can be done in the office setting under local anaesthesia.
Catheter knotting is a rare complication of bladder catheterisation. Retention of catheter parts resulting in calculus formation is even rarer. We report a case of a vesical calculus formed over a broken and retained supra-pubic catheter which to the best of our knowledge has yet to be reported, along with three other cases of bladder catheter knotting.
Pros and cons of Percutaneous Nephrolithotripsy (PCNL) versus Extracorporeal Shockwave Lithotripsy (ESWL) have often been highlighted when one discusses on the management of renal stones. An oft quoted point is that PCNL entails a prolonged hospital stay whereas ESWL sessions are day surgical in nature. However, PCNL has superior stone clearance rate as compared to ESWL especially for lower pole stones. In addition, PCNL is more suitable for large bulk stones and when ancillary procedures are required e.g. endopyelotomy. The first 50 cases of successful tubeless PCNL were reported by Bellman et al in 1997. The remarkable recovery of patients in their series encouraged them to employ this technique as their technique of choice for the majority of their cases. A similar technique was employed on endopyelotomy by Liang et al and they concluded that this was a safe, less morbid and effective technique. We report our first case of tubeless PCNL.
One thousand one hundred and sixty three patients (male-852, female-311) with ureteric calculi requiring intervention were treated between April 1988 to July 1992. Four hundred and eleven cases were treated by ESWL Monotherapy, 414 by stone manipulation plus ESWL, 301 by retrograde ureteroscopic lithotripsy, 36 by percutaneous antegrade ureteroscopic lithotripsy and 1 case by open ureterolithotomy. There were 25 failures of the initial procedures. Only three cases that failed primary procedures required open surgery. Other complications include minor ureteric mucosal perforation (3%), infection (3%), transient moderate to gross haematuria (20%), loin ache (26.4%), irritative urination (34.4%) and low grade fever (30.1%). Current modalities used in the treatment of ureteric calculi produce good results and there is generally no primary role for any open surgery.
74 cases of radiologically proven urinary calculi between 1975 and 1979 were analysed by race, sex and age. The relative frequency of single and multiple stones was also studied. The disease was found in all the ethnic groups present in Limbang except for the Punans. Possible reasons for this observation of their apparent absence were given. The absence of patients from one of the Malay Kampongs in Limbang town was also noted.
Records of 183 patients with renal stones managed at Hospital Universiti Sains Malaysia between 1985 and 1995 were retrospectively evaluated. The commonest symptom was lumbar pain which may be associated with either frequency, blood stained urine or dysuria. One hundred and sixty-one patients (88%) had upper tract stones while the remainder had lower tract stones. Positive urine cultures were seen in 33 patients. The commonest organism isolated was Escherichia coli followed by Klebsiella aeruginosa and Staphylococcus aureus. Almost all of our patients had renal impairment at presentation and 70% of them progressed to chronic renal failure. In contrast to previous findings, the pattern of renal stone in this region is similar to that described in Western society. Its effect on renal function is serious and hence warrant special attention.
The incidence of ureteric calculus as a cause for severe abdominal pain in children is mounting, especiallyin the tropical country. The course of illness may be non-specific but a swift detection via non-invasiveimaging modalities singly or in combination may avert unnecessary radiation hazard and futile surgery ina young child. In this paper, we discussed a case of an 11 year-old boy who was presented with a suddenonset of the right side severe abdominal colic whose a bedside ultrasound was positive for hydronephrosisfor which localisation of stone was further confirmed via a low dose limited intravenous urography (IVU).It is important to note that data available on the value of a combined ultrasound and the limited IVU inan emergency setting when urolithiais is being suspected in children with abdominal pain are particularlyscarce. Hence, this case documented the potential value of a combined ultrasound and a limited IVUstudy as a unique combined armamentarium used in a suspected childhood urolithiasis in the tropics.