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Potential of Fenugreek in Management of Kidney and Lung Disorders
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Amit D. Kandhare, Anwesha A. Mukherjee-Kandhare, Subhash L. Bodhankar
Urolithiasis or kidney stone is a common prevalent disorder of the urinary system caused by many etiological factors. Calcium oxalate-associated urolithiasis is the predominant (approximately 80%) amongst various pathologies of kidney stone (Butterweck and Khan 2009; Coe, Evan, and Worcester 2005). Evidence suggests that renal calculi formation is a complex process involving a series of physicochemical reactions within renal tubules, which include supersaturation, nucleation, development, aggregation, and retention (Alelign and Petros 2018). The current treatment options for urolithiasis management include non-pharmacological interventions, extracorporeal shockwave lithotripsy (ESWL), and laser of high magnitude. However, these surgical procedures may cause acute renal injury, and infections resulting in renal dysfunction and sometimes calculi recurrence (Shafi et al. 2016). The long-term treatment strategies include thiazide diuretics and alkali-citrate (K-citrate), which have been implicated for the prevalence of nephrolithiasis recurrence; however, these therapies showed poor efficacy (Shafi et al. 2016). A recent development in therapeutic research suggested that herbs played a significant role in treating kidney stones. The potential of Cystone, a polyherbal formulation, against urolithiasis has been well established, and thus approved by India’s drug regulatory authority for the treatment of urolithiasis (Erickson, Vrtiska, and Lieske 2011). Traditionally, fenugreek has also been suggested useful for treatment of kidney stone (Ahsan et al. 1989).
Acute abdomen in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Nicole Fearing, William L. Holcomb
A case:delivery ratio of approximately 1:1600 has been estimated for symptomatic urolithiasis in pregnancy (79,80). Stone passage seems to occur as often during pregnancy as outside of pregnancy. The causes for urolithiasis are varied. Among 78 women of reproductive age who were evaluated for urolithiasis, 42% had idiopathic hypercalciuria, 13% had hyperuricuria, 10% had primary hyperparathyroidism, 13% had infection stone, 3% had cystinuria, and 19% had idiopathic lithiasis (81).
Acute Abdomen in Pregnancy
Published in Lauren A. Plante, Expecting Trouble, 2018
Renal colic and pyelonephritis is the most common nonobstetric cause for abdominal pain during pregnancy (4). The incidence of pyelonephritis is 1–2% and is the most common nonobstetric cause for hospitalization during pregnancy (9). Pyelonephritis is associated with complications such as preterm labor, recurrent abortions, intrauterine growth restriction, and even fetal death. The treatment for pyelonephritis includes the administration of intravenous antibiotics, generally a broad-spectrum cephalosporin, in addition to providing supportive therapy through intravenous hydration and pain control until clinical improvement is observed. Antibiotic therapy can then be tailored to the specific organism after urine culture sensitivities are obtained. Intravenous antibiotic therapy should be continued for 24–48 hours after the patient becomes afebrile and clinical improvement is seen (for example, the absence of costovertebral tenderness). Treatment with oral antibiotics is recommended for 10–14 days with follow-up urine cultures in each trimester. Recurrent episodes are treated with suppressive therapy for the duration of the pregnancy, typically using 100 mg nitrofurantoin twice daily. If urolithiasis is suspected, a renal ultrasound is warranted. Most renal stones resolve spontaneously, typically as a result of the physiological hydroureter of pregnancy (10). For refractory cases, urological consultation is appropriate for the evaluation of stent placement or nephrostomy tubes. Lithotripsy is contraindicated in pregnancy.
Sex disparities and the risk of urolithiasis: a large cross-sectional study
Published in Annals of Medicine, 2022
Jin-Zhou Xu, Cong Li, Qi-Dong Xia, Jun-Lin Lu, Zheng-Ce Wan, Liu Hu, Yong-Man Lv, Xiao-Mei Lei, Wei Guan, Yang Xun, Shao-Gang Wang
This study still has several limitations. First, the study was designed as a cross-sectional survey, thus could explain little causality. Nevertheless, we concentrated on age this non-modifiable factor and established a dose-response relationship applying restricted cubic splines. Second, urolithiasis was diagnosed by ultrasonography rather than computed tomography. However, as a radiation-free and low-cost imaging method, ultrasonography was strongly recommended for screening in a large population and we also performed sensitivity analyses to minimise the impact of the low accuracy of ultrasonography [34]. Third, we lacked the analysis of the composition of stones. To compensate for that, we adjusted UpH to reflect the diverse stone types and urine chemistry [35]. Fourth, no information about the prior history and treatment of stone disease was obtained. Fifth, no dietary information and the history of other co-morbidities such as gout and bowel disease were obtained. Sixth, our analyses depended on single-centre physical examination information. Hence, it was arduous to eliminate the bias and further multicenter prospective studies were warranted.
Is extracorporeal shockwave lithotripsy (SWL) still suitable for >1.5 cm intrarenal stones? Data analysis of 1902 SWLs
Published in Scandinavian Journal of Urology, 2021
Wilmar Azal Neto, Enzo Morales, Marina Joseane Pachecco, Renato Nardi Pedro, Leonardo O. Reis
Urolithiasis is a prevalent disease around the globe. Its incidence is increasing over time, and it has been estimated that up to 8.8% of the United States of America’s population will be affected by this condition [1]. Currently, kidney stones are treated by minimally invasive surgical modalities such as extracorporeal shockwave lithotripsy (SWL), flexible ureteroscopy (FURS) and percutaneous nephrolithotomy (PCNL). According to the American Urological Association (AUA) and European Association of Urology (EAU) guidelines, SWL is the least-invasive procedure and it can be an option for kidney calculi smaller than 2 cm [1,2]. However, it is well known that SWL stone-free rates (SFRs) decline as stone size increases, making endourological approaches more suitable for bigger lithiasis burden [1–3].
Achievement of the target serum urate level among patients with gout treated with allopurinol or febuxostat in an arthritis clinic in the Philippines
Published in Modern Rheumatology, 2021
John Elmer Cabang Quilisadio, Evelyn Osio Salido, Ester Gonzales Penserga
Although the management of gout was based on the available local (Philippine Rheumatology Association) and international guidelines (American College of Rheumatology and European League Against Rheumatism), the authors acknowledge the limitations in this study that might contributed to the non-achievement of the target SUA level such as; the difference of the education among physicians were not included in the logistic regression, adherence to ULT was not objectively assessed, the patients’ under- and over-reporting of the adherence questionnaire forms, and the diet among patients were not properly documented. The glomerular filtration rate was estimated using the CKD-EPI formula rather than direct measurement. In documenting metabolic syndrome, not all patients have baseline fasting blood sugar (FBS), glycosylated hemoglobin (HBa1C), 2-hour glucose tolerance test (OGTT), and lipid profile results. Coronary heart disease and peripheral arterial disease were based on patients’ previous medical diagnosis. Urolithiasis was documented based on patients’ medical history whether imaging studies was done.