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Fulltext In vitro effects of plantago major extract on urolithiasis

Aziz SA, See TL, Khuay LY, Osman K, Abu Bakar MA

Malays J Med Sci, 2005 Jul;12(2):22-6.
PMID: 22605954

The study was carried out to determine the in vitro effect of Plantago major extract on calcium oxalate crystals and to compare the effects of Plantago major extract with clinically used drugs like allopurinol and potassium citrate (positive controls). Modified Schneider slide gel method was used for the in vitro study and the crystals formed were measured by Image Analyser system KS 300, 3.0 Carl Zeiss. The concentrations of Plantago major extract used were from 100ppm to 350ppm. Plantago major extract at concentrations in the range of (100ppm-350ppm) significantly inhibited the size of calcium oxate crystals (dihydrate variety) against negative control (p<0.05) and against positive controls (p<0.05). However the inhibition concentration 50 (IC(50)) values on the size of calcium oxalate crystal for the extract, potassium citrate and allopurinol were 300ppm, 350ppm and 450ppm respectively. Extract of Plantago major also has inhibition effect on the number of crystals but it was not significant. In conclusion extract of Plantago major was better than allopurinol and potassium citrate in inhibiting the size of the calcium oxalate crystal in-vitro.

Matched MeSH terms: Urolithiasis
Fulltext Investigation of potential anti-urolithiatic activity from different types of Musa pseudo-stem extracts in inhibition of calcium oxalate crystallization

Abu Zarin M, Tan JS, Murugan P, Ahmad R

BMC Complement Med Ther, 2020 Oct 19;20(1):317.
PMID: 33076892 DOI: 10.1186/s12906-020-03113-0

BACKGROUND: The banana or scientifically referred to as Musa sp., is one of the most popular fruits all over the world. Almost all parts of a banana tree, including the fruits, stem juice, and flowers are commonly used as traditional medicine for treating diarrhoea (unripe), menorrhagia, diabetes, dysentery, and antiulcerogenic, hypoglycemic, antilithic, hypolipidemic conditions, plus antioxidant actions, inflammation, pains and even snakebites. The study carried out was to evaluate in vitro anti-urolithiatic activity from different types of Musa pseudo-stems.
METHODS: Observing anti-urolithiathic activity via in vitro nucleation and aggregation assay using a spectrophotometer followed by microscopic observation. A total of 12 methanolic extracts were tested to determine the potential extracts in anti-urolithiasis activities. Cystone was used as a positive control.
RESULTS: The results manifested an inhibition of nucleation activity (0.11 ± 2.32% to 55.39 ± 1.01%) and an aggregation activity (4.34 ± 0.68% to 58.78 ± 1.81%) at 360 min of incubation time. The highest inhibition percentage in nucleation assay was obtained by the Musa acuminate x balbiciana Colla cv "Awak Legor" methanolic pseudo-stem extract (2D) which was 55.39 ± 1.01%at 60 min of incubation time compared to the cystone at 30.87 ± 0.74%. On the other hand,the Musa acuminate x balbiciana Colla cv "Awak Legor" methanolic bagasse extract (3D) had the highest inhibition percentage in the aggregation assay incubated at 360 min which was obtained at 58.78 ± 1.8%; 5.53% higher than the cystone (53.25%).The microscopic image showed a great reduction in the calcium oxalate (CaOx) crystals formation and the size of crystals in 2D and 3D extracts, respectively, as compared to negative control.
CONCLUSIONS: The results obtained from this study suggest that the extracts are potential sources of alternative medicine for kidney stones disease.

Matched MeSH terms: Urolithiasis/drug therapy*
Fulltext A housewife with recurrent pelvic pain

Loh KY

Family Physician, 2005;13(3):16-17.
MyJurnal

A 45-year-old Malay housewife was seen at a health clinic with the chief complain of recurrent lower abdominal pain for 9 months. The pain was colicky in nature and occasionally it radiated to the back. There was no history of fever, vaginal discharge or any urinary or bowel symptoms. She had been using an intrauterine contraceptive device (IUCD Cu250) for the past 5 years. The last change of the IUCD was 2 years ago. Her annual pap smear results were normal. She had been to many primary care clinics and was reassured by the doctors that her symptom was due to her IUCD. She was prescribed mefenamic acid repeatedly for the past 9 months. However her symptoms worsen and she was worried because prior to this she did not have similar problems. Her physical examination was unremarkable. On pelvic examination, the IUCD string was visualised, indicating that her IUCD was still in-situ. Her cervix was pink and healthy. There was no abnormal vaginal discharge.

Matched MeSH terms: Urolithiasis*
Fulltext Combined ultrasound and IVU for the management of childhood Urolithiasis: a case report

Fathinul Fikri, A.S., Abdul Jalil Nordin

Pertanika Journal of Science & Technology, 2012;20(2):327-330.
MyJurnal

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.

Matched MeSH terms: Urolithiasis
Laser-induced breakdown spectroscopy-Raman: An effective complementary approach to analyze renal-calculi

Muhammed Shameem KM, Chawla A, Mallya M, Barik BK, Unnikrishnan VK, Kartha VB, et al.

J Biophotonics, 2018 06;11(6):e201700271.
PMID: 29411942 DOI: 10.1002/jbio.201700271

Presence of renal-calculi (kidney stones) in human urethra is being increasingly diagnosed over the last decade and is considered as one of the most painful urological disorders. Accurate analysis of such stones plays a vital role in the evaluation of urolithiasis patients and in turn helps the clinicians toward exact etiologies. Two highly complementary laser-based analytical techniques; laser-induced breakdown spectroscopy (LIBS) and micro-Raman spectroscopy have been used to identify the chemical composition of different types of renal-calculi. LIBS explores elemental characteristics while Raman spectroscopy provides molecular details of the sample. This complete information on the sample composition might help clinicians to identify the key aspects of the formation of kidney stones, hence assist in therapeutic management and to prevent recurrence. The complementarity of both techniques has been emphasized and discussed. LIBS spectra of different types of stones suggest the probable composition of it by virtue of the major, minor and trace elements detected from the sample. However, it failed to differentiate the crystalline form of different hydrates of calcium oxalate stone. This lacuna was overcome by the use of Raman spectroscopy and these results are compared with conventional chemical analysis.

Matched MeSH terms: Urolithiasis
Fulltext Retrocaval ureter: the importance of intravenous urography

Hassan R, Aziz AA, Mohamed SK

Malays J Med Sci, 2011 Oct;18(4):84-7.
PMID: 22589677

Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.

Matched MeSH terms: Urolithiasis
Assessment and clinical significance of haematuria in Malaysian patients - relevance to early cancer diagnosis

Ng KL, Htun TH, Dublin N, Ong TA, Razack AH

Asian Pac J Cancer Prev, 2012;13(6):2515-8.
PMID: 22938414

AIM: To study the causes and significance of both microscopic and macroscopic haematuria in adult patients and assess possible relevance to early detection of urological cancers.
METHODS: 417 patients presenting with haematuria were assessed in our Urology Unit. Following confirmation of haematuria, these patients were subjected to imaging techniques and flexible cystoscopy. Parameters analysed included clinical characteristics, imaging results, flexible cystoscopy findings, time delay to diagnoses and eventual treatment and final diagnoses of all cases.
RESULTS: 390 haematuria cases were analysed from 417 consecutive patients with haematuria. After 27 cases were excluded as they had previous history, 245 microscopic and 145 macroscopic. Age range was 17 to 95 years old with predominance of 152 females to 239 males. The racial distribution included 180 Chinese, 100 Indians,95 Malays and 15 other races. The final diagnoses were benign prostatic hyperplasia (22.6%), no cause found (22.3%), other causes (18.7%), urolithiasis (11.5%), urinary tract infection UTI (10.8%), non specific cystitis (10.3%), bladder tumours (2.8%) and other genitourinary tumours (1%). 11 new cases (2.8%) of bladder cancers were diagnosed, with a mean age of 59 years. Only 3 of 245 (1.2%) patients with microscopic haematuria had newly diagnosed bladder tumour compared with 8 of 145 (5.5%) patients with frank haematuria (p=0.016). Mean time taken from onset of symptoms to diagnosis of bladder cancer was 53.3 days with definitive treatment (TURBT) in 20.1 days from diagnosis.
CONCLUSION: - This study has highlighted the common causes of haematuria in our local setting. We recommend that full and appropriate investigations be carried out on patients with frank haematuria especially those above 50 years old in order to provide earlier detection and prompt management of bladder diseases especially tumours.

Matched MeSH terms: Urolithiasis/diagnosis*
Twenty-four-hour urine constituents in stone formers: a study from the northeast part of Peninsular Malaysia

Hussein NS, Sadiq SM, Kamaliah MD, Norakmal AW, Gohar MN

Saudi J Kidney Dis Transpl, 2013 May;24(3):630-7.
PMID: 23640651

Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospitals in the same geographical region; 96 patients fulfilled the inclusion criteria and an informed consent was obtained from all subjects. The 24-h urine was collected in sterile bottles with a preservative agent and calcium, oxalate, citrate, uric acid, magnesium and phosphate were tested using commercial kits on a Roche Hitachi 912 chemistry analyzer. The age (mean ± SD) of 96 patients was 56.45 ± 13.43 years and 82.3% of the patients were male while 17.7% were female. The 24-h urine abnormalities were hypercalciuria (14.5%), hyperoxaluria (61.4%), hypocitraturia (57.2%), hyperuricouria (19.7%), hypomagnesuria (59.3%) and hyperphosphaturia (12.5%). Hyperoxaluria (61.4%) was the most common abnormality detected during the analysis of 24-h urine constituents in contradiction to industrial countries, where hypercalciuria was the most common finding. The high frequencies of hypomagnesuria and hypocitraturia reflect the important role of magnesium and citrate in stone formation and their prophylactic role in the treatment of urinary stone disease in the given population.

Matched MeSH terms: Urolithiasis/epidemiology; Urolithiasis/urine*
Fulltext Congenital mastoid cholesteatoma presenting as a mass obstructing external auditory canal

Khairunnisak M, Mohd Khairi MD

Med J Malaysia, 2014 Dec;69(6):277-8.
PMID: 25934960 MyJurnal

We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 - 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck's traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.

Matched MeSH terms: Urolithiasis
Fulltext Satisfaction and perceptions of patients toward kidney stones disease management: a review of literature

Nouri, Ahmed Ibrahim, Hassal, Mohamed Azmi, Allayla, Tuqa Haitham

Malaysian Journal of Pharmaceutical Science, 2018;16(1):55-60.
MyJurnal

Urolithiasis considered as a disease condition that is neglected in terms of research because of its perceived low prevalence and possibly the seemingly good prognosis associated with it. However, in recent years, the prevalence of urolithiasis is increasing in both developed and developing countries and the disease is associated with significant burden and healthcare cost from patients’ caregivers, and society’s perspective. All healthcare providers (including pharmacists) have an important role to play in the management of this disease and it deserves more attention in terms of clinical practice and research. This review aims to provide a comprehensive understanding of patient satisfaction, from the aspect of defining satisfaction of patients, perceptions toward disease management, and a review of literature of satisfaction of patients with kidney stones and its magnitude in healthcare provided. The medical literature has many articles about urolithiasis management options. However, there have been no sufficient published studies discussing patient-reported outcomes of kidney stone management to evaluate their satisfaction, preferences, treatment expectations, and quality of life. Future studies are needed to spot the light on kidney stones patients’ preferences and reported outcomes.

Matched MeSH terms: Urolithiasis
Fulltext Clinical management of dietary induced urolithiasis associated with balanoposthitis in a Boer goat

Abba Y, Abdullah FF, Daud NH, Shaari RB, Tijjani A, Sadiq MA, et al.

Open Vet J, 2015;5(1):30-3.
PMID: 26623360

A Boer-Kajang cross male goat was presented to the Veterinary Hospital, University Malaysia Kelantan with a history of dysuria, hematuria and restlessness. The goat was intensively managed (confined to the pen) and fed with only palm kernel cake for the last three months. Physical examination revealed that the goat was dull, depressed, having an inflamed penis and prepuce with blood stained urine dripping from the penis. The differential diagnoses were obstructive urolithiasis, urinary tract infection and balanoposthitis. Based on the history, clinical signs, physical examination, urinalysis, ultrasonagraphy and feed analysis, the goat was diagnosed with obstructive urolithiasis and balanoposthitis. Treatment was instituted by amputation of the urethral process and retrograde urohydropulsion to relieve the blockade. Sulfadiazine-trimethoprim (Norodine(®)24) 15mg/kg, I.M; flunixin meglumine 2.2mg/kg, I.M; vitamin B complex 1ml/10kg, I.M and ammonium chloride 300mg/kg orally were administered. The goat responded well to treatment and was recovering well during a follow up visit.

Matched MeSH terms: Urolithiasis
Fulltext Pharmacological Evaluation of Safoof-e-Pathar Phori- A Polyherbal Unani Formulation for Urolithiasis

Ahmad W, Khan MA, Ashraf K, Ahmad A, Daud Ali M, Ansari MN, et al.

Front Pharmacol, 2021;12:597990.
PMID: 33935697 DOI: 10.3389/fphar.2021.597990

Safoof-e-Pathar phori (SPP) is an Unani poly-herbomineral formulation, which has for a long time been used as a medicine due to its antiurolithiatic activity, as per the Unani Pharmacopoeia. This powder formulation is prepared using six different plant/mineral constituents. In this study, we explored the antiurolithiatic and antioxidant potentials of SPP (at 700 and 1,000 mg/kg) in albino Wistar rats with urolithiasis induced by 0.75% ethylene glycol (EG) and 1% ammonium chloride (AC). Long-term oral toxicity studies were performed according to the Organization for Economic Co-operation and Development (OECD) guidelines for 90 days at an oral dose of 700 mg/kg of SPP. The EG urolithiatic toxicant group had significantly higher levels of urinary calcium, serum creatinine, blood urea, and tissue lipid peroxidation and significantly (p < 0.001 vs control) lower levels of urinary sodium and potassium than the normal control group. Histopathological examination revealed the presence of refractile crystals in the tubular epithelial cell and damage to proximal tubular epithelium in the toxicant group but not in the SPP treatment groups. Treatment of SPP at 700 and 1,000 mg/kg significantly (p < 0.001 vs toxicant) lowered urinary calcium, serum creatinine, blood urea, and lipid peroxidation in urolithiatic rats, 21 days after induction of urolithiasis compared to the toxicant group. A long-term oral toxicity study revealed the normal growth of animals without any significant change in hematological, hepatic, and renal parameters; there was no evidence of abnormal histology of the heart, kidney, liver, spleen, or stomach tissues. These results suggest the usefulness of SPP as an antiurolithiatic and an antioxidant agent, and long-term daily oral consumption of SPP was found to be safe in albino Wistar rats for up to 3 months. Thus, SPP may be safe for clinical use as an antiurolithiatic formulation.

Matched MeSH terms: Urolithiasis
Fulltext Urinary bladder rupture secondary to obstructive urolithiasis in a Jamnapari goat

Tan, Y.K., Hiew, M.W.H., Radzi, R., Khairuddin, N.H.

Jurnal Veterinar Malaysia, 2017;29(2):20-24.
MyJurnal

This report describes the complications of obstructive urolithiasis in the lower urinary tract causing urinary bladder rupture in a Jamnapari buck. A 3-year-old Jamnapari buck was presented with the complaint of stranguria, subsequent anuria and a progressively distended abdomen for the past three days. Upon physical examination, body temperature, pulse rate and respiration rate were increased. Uroliths could be felt within the urethra in the ventral abdomen region. A urolith was removed via amputationof the urethral process, but the patency of the urethra could not be established. Transabdominal ultrasound revealed anechoic areas around the bladder, and the bladder was relatively small for a urinary obstructed goat. The bladder wall was thickened and shadow of sludge was observed within the bladder. Abdominocentesis was done and fluid analysis revealed that it was a haemorrhagic effusion. Blood results revealed renal disease, liver disease, muscle injury and haemoconcentration. Retrograde cystourethrogram revealed no urolithswithinthe urethra but there was leakage of the contrast agent from the bladder into the peritoneal cavity. The final diagnosis was complete blockage of the lower urinary tract leading to bladder rupture. Exploratory laparotomy was done and emergency cystorraphy was planned. Due to the poor condition of the urinary bladder with presence of septic peritonitis, the goat was euthanised.

Matched MeSH terms: Urolithiasis
Fulltext Knowledge, awareness and dietary practice on urolithiasis among general population in Kuantan, Pahang, Malaysia: Preliminary findings

Sowtali SN, Ariffin SRM, Nazli NS, Shukri NABM, Khattak MMAK, Ab Rashid IM, et al.

J Public Health Res, 2021 Apr 14;10(2).
PMID: 33855421 DOI: 10.4081/jphr.2021.2238

BACKGROUND: To date, no studies have been published at evaluating the level of knowledge, awareness and practice of dietary, particularly regarding to urolithiasis in patients or the general population. This study aims to provide basic information on the level of knowledge, awareness and dietary practice among general population in Kuantan, Pahang.
DESIGN AND METHODS: The respondents (n=30) were conveniently recruited within 10 kilometres radius of Kuantan city. The data were obtained using semi-guided administered questionnaires, which consists of four parts: socio-demographic data, lifestyle and clinical history (Part A); attitude and awareness on dietary practice regarding urolithiasis (Part B); food frequency questionnaire on urolithiasis (Part C) and level of knowledge on urolithiasis (Part D).
RESULTS: Majority of the respondents were women (70%), Malay (83.3%), mean age of 33.97 (±9.27), married (63.3%), completed higher education level (60%), working with government sector (33.3%) and have fixed monthly income (53.3%). Some of them had hypertension (n=4), diabetes (n=1), gout (n=1) and intestinal problem (n=1). Majority (80%) claimed having no family history of urolithiasis, consumed alcohol (10%), exercise with average frequency 2-3 times/week (46.7%) and heard about urolithiasis from healthcare worker (46.7%). The respondents' awareness about urolithiasis is considered to be good [81.23 (±9.98)] but having poor knowledge score [2.70 (±1.149)]. Majority preferred wholemeal bread, white rice, chicken meat, mackerel fish, chicken egg, apple, carrot, mustard leave and fresh milk in daily intake. Lesser plain water intake than standard requirement was noticed among respondents. Seasoning powder was commonly used for seasoning.
CONCLUSIONS: Generally, the general population of Kuantan, Pahang was aware of urolithiasis disease but needed more information on dietary aspect in terms of knowledge and food choice.

Matched MeSH terms: Urolithiasis

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