MyMedR

A case report of primary hyperparathyroidism with severe bony involvement and nephrolithiasis

Chan SP, Hew FL, Jayaram G, Kumar G, Chang KW, Tay A

Ann Acad Med Singap, 2001 Jan;30(1):66-70.

INTRODUCTION: Although the majority of patients with primary hyperparathyroidism have a relatively asymptomatic benign disorder, there are patients who have a more aggressive disorder.

CLINICAL PICTURE: We report a case of primary hyperparathyroidism presenting during pregnancy complicated by antepartum haemorrhage and severe prematurity. The diagnosis was made postpartum, when her problems rapidly progressed to result in severe neuromuscular weakness, bilateral pathological hip fractures as well as nephrolithiasis.

TREATMENT: Surgical parathyroidectomy was performed. The underlying lesion was a large solitary parathyroid adenoma with cystic elements.

CONCLUSION: Primary hyperparathyroidism is not an innocuous disease and can result in severe morbidity if left untreated.

Matched MeSH terms: Kidney Calculi/etiology*

Fulltext The Effects Of Alcohol-free 0.12% W/N Chlorhexidine Gluconate Mouthrinse On Oral Health

Uma, S., Swaminathan, D.

Ann Dent, 2001;8(1):-.

MyJurnal

CWorhexidine gluconate, a dicationic bisbiguanide agent, contains anti-plaque properties. Most chlorhexidine gluconate mouth rinses presently available contain alcohol in varying concentrations. The role of alcohol in these mouth rinses is to act as a preservative and solvent although it may have deleterious effects on the oral epithelium on long term usage. Recently, an alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse (Oradex®) has become available in Malaysia. This clinical study is aimed at determining the effects of this alcohol-free product compared to a placebo. A group of 60 meticulously screened subjects were assigned into two groups of 30 each. The first group started using the test product for 2 weeks followed by a washout period of 4 weeks. After this duration, this group used the placebo for a further 2 weeks. The 2nd group underwent similar protocol as the 1st except that this group started with the placebo. Measurements consisting of the following scores were recorded at baseline and after 2 weeks for each group: Plaque, Gingivitis: Papillary Bleeding, Stain and Calculus. Full mouth prophylaxis was carried out for all subjects after measurements at baseline as well as after the 2-week period. They were told to rinse with 15 ml of the designated mouth rinse twice daily for thirty seconds each after tooth brushing. The results of this study indicated that there was significant improvement in the plaque, gingival and papilla bleeding scores compared to the placebo. Stain and calculus scores were significantly increased for the test product when compared to the placebo. In conclusion, this study showed that alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse is effective in reducing plaque and gingivitis but causes staining and calculus formation.

Matched MeSH terms: Calculi

Multielement analysis of human hair and kidney stones by instrumental neutron activation analysis with the k0-standardization method

Abugassa I, Sarmani SB, Samat SB

Appl Radiat Isot, 1999 Jun;50(6):989-94.

PMID: 10355102

This paper focuses on the evaluation of the k0 method of instrumental neutron activation analysis in biological materials. The method has been applied in multielement analysis of human hair standard reference materials from IAEA, No. 085, No. 086 and from NIES (National Institute for Environmental Sciences) No. 5. Hair samples from people resident in different parts of Malaysia, in addition to a sample from Japan, were analyzed. In addition, human kidney stones from members of the Malaysian population have been analyzed for minor and trace elements. More than 25 elements have been determined. The samples were irradiated in the rotary rack (Lazy Susan) at the TRIGA Mark II reactor of the Malaysian Institute for Nuclear Technology and Research (MINT). The accuracy of the method was ascertained by analysis of other reference materials, including 1573 tomato leaves and 1572 citrus leaves. In this method the deviation of the 1/E1+ alpha epithermal neutron flux distribution from the 1/E law (P/T ratio) for true coincidence effects of the gamma-ray cascade and the HPGe detector efficiency were determined and corrected for.

Matched MeSH terms: Kidney Calculi/chemistry*

Fulltext Oral Health Profile Of A Group Of Malayasian Drug Addicts

Sujak, S.L., Abdul Kadir, R.

Ann Dent, 1999;6(1):-.

MyJurnal

A study was undertaken to identify the oral health status and treatment needs of 403 drug abusers enrolled in a drug rehabilitation center in Perak, Malaysia. The prevalence of dental caries was 97.0%. Calculus was present in 82.1% of the dentate individuals, but only 14.6% had pockets greater than 3mm. The mean DMFT observed was 11.7, with missing teeth (MT=9.6) constituting the major component. Denture needs were high (67.2%), but only 11.4% of individuals had prostheses.

Matched MeSH terms: Calculi

Fulltext Renal stones in Kelantan, Malaysia--has the pattern changed?

Nazmi N, Zainal D, Hashim M

Southeast Asian J. Trop. Med. Public Health, 1997 Sep;28(3):641-4.

PMID: 9561623

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.

Matched MeSH terms: Urinary Calculi/diagnosis*; Urinary Calculi/etiology*; Urinary Calculi/therapy

Clinico-radiologic-pathologic conference. Abnormal findings on chest radiographs of an asymptomatic patient

Staples CA, Brown MJ, Bai TR, Chan NH

Can Assoc Radiol J, 1996 Apr;47(2):136-9.

PMID: 8612087

Matched MeSH terms: Calculi/ethnology; Calculi/pathology

Fulltext Multimodal approach in the management of 1163 ureteric stone cases

Tan HM, Liew RP, Chan CC, Wong AT, Ngun KW

Med J Malaysia, 1995 Mar;50(1):87-92.

PMID: 7752983

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.

Matched MeSH terms: Ureteral Calculi/therapy*

Fulltext Giant urethral calculus

Win T

Singapore Med J, 1994 Aug;35(4):414-5.

PMID: 7899907

This is a case report of a 56-year-old Malay male presenting with a giant urethral calculus. The stone measuring 70 X 50 X 40 mm and weighing 45 g was impacted in the posterior urethra. The giant urethral calculus was removed successfully through external urethrotomy.

Matched MeSH terms: Urinary Calculi/diagnosis*; Urinary Calculi/surgery

Fulltext Urinary erythrocyte morphology as a diagnostic aid in haematuria

Ahmad G, Segasothy M, Morad Z

Singapore Med J, 1993 Dec;34(6):486-8.

PMID: 8153706

The value of urinary erythrocyte morphology in diagnosing glomerular and nonglomerular haematuria was studied using phase contrast microscopy in 105 patients with significant haematuria. Fifty-eight (93.6%) out of 62 patients with glomerulonephritis had dysmorphic erythrocytes and 40 (93.1%) out of the 43 patients with nonglomerular disease had isomorphic erythrocytes in the urine. A mixed picture of glomerular and nonglomerular haematuria was seen in 5 patients. The sensitivity was 93.6%, the specificity was 97.7% and the positive predictive value was 98.3% for glomerulonephritis in patients with dysmorphic haematuria. The positive predictive value for a nonglomerular source of bleeding was 96.7% with isomorphic haematuria. It is concluded that phase contrast microscopic examination of erythrocytes in urine is a simple, inexpensive and noninvasive technique that reliably distinguishes between glomerular and nonglomerular bleeding in patients.

Matched MeSH terms: Kidney Calculi/diagnosis; Kidney Calculi/urine

Fulltext Xanthogranulomatous pyelonephritis in a Malaysian population

Koh KB

Singapore Med J, 1993 Aug;34(4):341-2.

PMID: 8266209

Xanthogranulomatous pyelonephritis is a clinico-pathological entity that is gaining awareness amongst urologists worldwide. It is an unusual chronic inflammatory lesion involving the kidney that destroys renal parenchyma and may mimic renal carcinoma. It is usually seen in middle-aged women and is associated with urinary tract infections and urinary calculi. Most reports and reviews of this condition come from the West; this study reviews the incidence and presentation of the condition in a Malaysian population.

Matched MeSH terms: Urinary Calculi/epidemiology

Instrumental neutron activation analysis of kidney stones

Sarmani S, Kuan LL, Bakar MA

Biol Trace Elem Res, 1990 7 1;26-27:497-502.

PMID: 1704755

Kidney stone samples of the types calcium oxalate, uric acid, and xanthine were analyzed for their elemental contents by neutron activation analysis to study both the elemental correlation and influence of element on stone precipitation processes. Elements, such as Al, Au, Br, Ca, Cl, Co, Cr, Fe, Hg, I, K, Mg, Na, Sb, Se, Sr, and Zn, were determined quantitatively. Calcium oxalate stones contained higher concentration of all the elements analyzed compared to uric acid or xanthine stones. The concentrations of Cl, Fe, K, Na, Sr, and Zn were relatively higher than Au, Co, Cr, and Sb. A positive correlation exists between Ca and Zn, whereas a negative correlation exists between Sr and Ca. Zinc may play an important role in the formation of calcium oxalate stone.

Matched MeSH terms: Kidney Calculi/chemistry*

Urinary stones in Malaysia--its incidence and management

Sreenevasan G

Med J Malaysia, 1990 Jun;45(2):92-112.

PMID: 2152025

The life of Lord Moynihan is briefly reviewed. Incidence of stones in Peninsular Malaysia appears to show the same trend as in other industrialised countries. Management of urinary calculi both prior to and after the introduction of ESWL in a personal series is discussed. More than 90% of urinary stones are now treated by ESWL threatening the place of surgery in Urology. The pattern of incorporating renal transplantation into the urological training programme as practised in the Institute of Urology and Nephrology in Malaysia is suggested as a way to assure a place for surgery in Urology.

Matched MeSH terms: Kidney Calculi/epidemiology; Kidney Calculi/therapy

Fulltext Experience with 395 extracorporeal shockwave lithotripsy in the treatment of renal and ureteric calculi

Tan HM, Cheung HS

Med J Malaysia, 1990 Jun;45(2):113-7.

PMID: 2152014

Three hundred and ninety five cases in 358 consecutive patients (male-232, female-126) with renal and ureteric stones were treated with extracorporeal shockwave lithotripsy (ESWL) from March to November 1988. They either had ESWL alone, or in combination with stone manipulation or debulking percutaneous nephrolithotripsy (PCNL). Seventy five percent of the stones were found in the pelvicalyceal system and 25% in the ureter. Seventy-six percent of the stones were less than 25mm size. Two hundred and ninety (79%) cases were followed up to three months. Two hundred and forty nine (85.9%) cases were stone free and 36 (12.4%) had residual sand less than 3mm size. Five (1.7%) cases failed to fragment with ESWL monotherapy and were salvaged by either percutaneous or ureteroscopic intervention. None of the cases required any open surgery intervention.

Matched MeSH terms: Kidney Calculi/therapy*; Ureteral Calculi/therapy*

Fulltext Percutaneous renal surgery for urolithiasis

Tan HM, Cheung HS

Med J Malaysia, 1990 Jun;45(2):118-22.

PMID: 2152015

Sixty eight consecutive cases of percutaneous renal surgery, percutaneous nephrolithotripsy (PCNL), were performed on 64 patients (male-41, female-23) at the Subang Jaya Medical Centre from April 1988 to July 1989. All the cases were done as a one stage procedure. Fifty eight stones were large renal or staghorn and ten were ureteric. Thirty cases (41%) were stone free after PCNL alone. Thirty eight cases had residual fragments needing extracorporeal shockwave lithotripsy (ESWL). Mean operating time was 109.6 +/- 36.0 minutes. Mean hospital stay was 4.5 +/- 1.8 days. At three months follow-up, 86% of the cases were stone free. The remaining had residual sand (less than 3mm). Minor complications occurred in six patients. None required major surgical intervention post PCNL.

Matched MeSH terms: Kidney Calculi/surgery*; Kidney Calculi/therapy; Ureteral Calculi/surgery*; Ureteral Calculi/therapy

[Descriptive epidemiology of urolithiasis]

Kodama H, Ohno Y

Hinyokika Kiyo, 1989 Jun;35(6):923-34.

PMID: 2678977

In this paper, urolithiasis is remarked from the standpoint of descriptive epidemiology, which examines the frequency distribution of a given disease in a population in terms of time, place and personal characteristics with an aim of identifying risk factors or some clues to the etiology. Some descriptive epidemiological features of urolithiasis are summarized. Prevalence rate is around 4% (4-15% in males and 4-8% in females), and incidence rate varies from area to area: 53.2 per 100,000 population in 1975 in Japan, 364 in 1976 in Malaysia, and 540 in 1979 in West Germany. Prevalence and/or incidence rates have, in general, increased in the developed countries since World War II and in the developing countries as well, where upward trends are quite analogous to the trends observed in the nineteenth century in Europe. Recurrence rate, which is much higher in males than in females, ranges from 31% to 75%, depending on the follow-up periods. In the industrialized countries, upper urinary (renal and ureteral) stones account for more than 90% of total stones, which are ordinarily calcium complexes in composition. More common in the developing countries are lower urinary (bladder and urethral) stones, frequently composed of magnesium ammonium phosphate, which indicates a close association with urinary tract infections. Variations in frequency are evident by season and by region within a country. Age and sex differentials in urinary stone formers are substantial: more common in males 30-40 years old in the industrialized countries and in children under 10 years old in the developing countries. Racial differentials are also noted; blacks appear to suffer less frequently than whites. Stone formers experience more frequent episodes of stone formation in their family members, particularly father and brothers, than non-stone formers. These findings on racial differentials and family preponderance suggest the possible relevance of genetic factors in stone formation. Stone formers are more likely to be occupationally sedentary and socially affluent. This observation and differentials by age and sex suggest the probable relevance of lifestyle and environmental factors in stone formation. Epidemiological factors incriminated for stone formation will be discussed in a separate paper.

Matched MeSH terms: Urinary Calculi/genetics; Urinary Calculi/epidemiology*

Fulltext Outflow obstruction and bladder stones in Kelantan

McAll G, Lim KG, Edward R

Med J Malaysia, 1989 Mar;44(1):52-7.

PMID: 2626113

Bladder stones in men are thought to be almost exclusively due to outflow obstruction. We studied the incidence of operations for urinary outflow obstruction and bladder stone to establish the relationship between these two conditions in Kelantan. In only 48 (31%) of 154 men undergoing removal of bladder stones was a procedure for outflow obstruction performed. Thus the remaining 69% had no clinical obstruction to account for their stones. Bladder stones were more common in prostatectomy patients than expected (42/193: 22%). We suggest that other causes may be important in the aetiology of bladder stones in Kelantan.

Matched MeSH terms: Urinary Bladder Calculi/etiology*; Urinary Bladder Calculi/surgery

Fulltext Urinary stones in Kelantan, Malaysia--a two year review

Lim KG, Edward RH, McAll GLG, Thaung M, Wahad NA, Arimainayagam G

Singapore Med J, 1988 Aug;29(4):353-6.

PMID: 3249962

216 patients were found to have had surgery for urinary calculi In a retrospective analysis of surgical records of the two general hospitals in Kelantan over a two year period. Excluding 11 patients from Terengganu and 2 patients resident in Kelantan for less than 1 year, this amounts to an annual incidence for calculus surgery of 10 per 100,000 residents per year. Lower urinary tract (LT) calculi (143) were more common than upper urinary tract (UT) calculi (71). There was an overwhelming majority of males among patients operated on for LT calculi (ratio of males:females = 1.2:1). The mean age of patients with UT calculi was 44 years, while that of LT calculi was 51 years.

Matched MeSH terms: Urinary Calculi/surgery*

Fulltext Endourology new vistas in the management of urinary tract disease

Mahamooth Z

Med J Malaysia, 1987 Sep;42(3):191-5.

PMID: 3506643

Retrograde ureteroscopy, using the 12.5 French Storsz Perez-Castro Ellendt operating ureteroscope provides excellent visual access to the whole of the ureteric lumen in most instances. A total of 41 ureteroscopies were performed on a similar number of patients over a period of 12 months since April 1986. Majority of them were for ureteric calculi. Success rate for patients with ureteric calculi below the pelvic brim was 77.4%. A lower success was noted for calculi above the pelvic brim (50%). Retrograde ureteroscopy will eventually make blind basketing of lower ureteric stones an unnecessarily risky procedure and perhaps even obsolete. Ureterolithotomy nevertheless will still have a place in the management of stones that cannot be extracted either due to acute bullous oedema of the ureteric mucosa or in previously explored rigid non-yielding ureters not suitable for ureteroscopy.

Matched MeSH terms: Ureteral Calculi/diagnosis; Ureteral Calculi/therapy*

Fulltext Incidence of urinary stones in the various states of mainland Malaysia

Sreenevasan G

Med J Malaysia, 1981 Sep;36(3):142-7.

PMID: 7329370

A study into the incidence of urinary calculi over a 15-year period from 1962-1976 in the states of mainland Malaysia is presented. Figures from the Ministry of Health Returns are the only source for such information. The incidence from the various states over each five year period from 1962-1972 is tabulated and its significance especially, the pattern of incidence, and its relation to industrialisation is discussed. Malaysia is beginning to show the same pattern of incidence in the upper and lower urinary tract as that of other industrialised countries. A plea is made for the establishment of a central register at the Institute of Urology and Nephrology to carry out a national survey of urinary calculi so that a study into the epidemiology, and if possible, preventive aspects of urolithiasis can be undertaken.

Matched MeSH terms: Urinary Calculi/etiology; Urinary Calculi/epidemiology*

Fulltext Bilateral stones and renal failure

Suleiman AB, Awang H, Proehoeman F

Med J Malaysia, 1981 Mar;36(1):14-6.

PMID: 7321931

The clinical presentation of patients with bilateral stones is discussed. The majority of patients presenting to the Nephrology Unit were in renal failure. Aggressive medical treatment allowed
diagnostic procedures and definitive surgery to be performed in uraemic patients. Most patients presenting in uraemia benefitted from treatment.
Study Site: Urology Unit, General Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Kidney Calculi/complications*; Kidney Calculi/therapy

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