Hydronephrosis due to renal calculi. I think in that particular situation modern system of medicine totally depend on surgical intervention. In cases of severe hydronephrosis that are not treated promptly, scarring of the kidney can occur. In the most serious of cases, this can lead to kidney failure/Azotemia. Homoeopathic medicines are useful and depends upon size and nature of calculi. Berberis vulgaris Q is one of them. Any history of UTI forming struvite stones wonderful medicine is Cantheris Q. Otherwise proper case taking oriented dilution based medicines are effective.
IMPRESSION -1--MILD HEPATOMEGALY & FATTY INFILTRATION OF LIVER (GRADE -1),,2--RT. RENAL MULTIPLE CALCULI, ,3--LEFT UPPER URETERIC CALCULUS CAUSING MILD HYDRONEPHROSIS & PROXIMAL HYDROURETER, ,4--LEFT RENAL MULTIPLE SMALL CALYCEAL CALCULI.
Pain, hydronephrosis@ due to renal calculi. Ayurvedic medicine that can be used is Tab. Neeri 2 tab. TDS, Tab. Calcury 2tab. TDS, Gokshuradi guggulu 2 tab. BD with lots of water, coconut water, Citrus fruit juice.
A case of multiple calculus in both Ureters caused hydronephrosis Serum calcium report? Homoeopathic treatement berbaris Vulg, Lycopodium, sarsaparilla Hydrangea,is used according to Similimum thanku
Calc Carb-30 thrice a day Verbaris Vul Q twenty drops thrice a day with hot water.after meal. Sarsaparilla-Q twenty drops thrice a day before meal.
Bilatrtal uro lithiasis with left obstructive uropathy
Cases that would interest you
- Login to View the image
40/f has right flank pain since 15 days with burning micturition. no fever/hematuria no h/o left loin pain hypothyroidism (TSH: 11, on eltroxin 50ugOD) xray image given how to proceed in this case? hypothyroidism management??Dr. Ashish Parikh5 Likes26 Answers
- Login to View the image
Friends today I am discussing about the Kidney Stones. Patient having renal stone have very severe pain along with many complications. What are kidney stones? Kidney stones, or renal calculi, are solid masses made of crystals. Kidney stones usually originate in your kidneys. However, they can develop anywhere along your urinary tract, which consists of these parts: kidneys ureters bladder urethra Kidney stones are one of the most painful medical conditions. The causes of kidney stones vary according to the type of stone. Types of kidney stones Not all kidney stones are made up of the same crystals. The different types of kidney stones include: Calcium Calcium stones are the most common. They’re often made of calcium oxalate (though they can consist of calcium phosphate or maleate). Eating fewer oxalate-rich foods can reduce your risk of developing this type of stone. High-oxalate foods include: potato chips peanuts chocolate beets spinach However, even though some kidney stones are made of calcium, getting enough calcium in your diet can prevent stones from forming. Uric acid This type of kidney stone is more common in men than in women. They can occur in people with gout or those going through chemotherapy. This type of stone develops when urine is too acidic. A diet rich in purines can increase urine’s acidic level. Purine is a colorless substance in animal proteins, such as fish, shellfish, and meats. Struvite This type of stone is found mostly in women with urinary tract infections (UTIs). These stones can be large and cause urinary obstruction. They result from a kidney infection. Treating an underlying infection can prevent the development of struvite stones. Cystine Cystine stones are rare. They occur in both men and women who have the genetic disorder cystinuria. With this type of stone, cystine — an acid that occurs naturally in the body — leaks from the kidneys into the urine. Risk factors for kidney stones The greatest risk factor for kidney stones is making less than one liter of urine per day. This is why kidney stones are common in premature infants who have kidney problems. However, kidney stones are most likely to occur in people between the ages of 20 and 50. Different factors can increase your risk of developing a stone. Typically, Caucasians are more likely to have kidney stones than those of African descent. Sex also plays a role. More men than women develop kidney stones, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). A history of kidney stones can increase your risk. So does a family history of kidney stones. Other risk factors include: dehydration obesity a diet with high levels of protein, salt, or glucose hyperparathyroid condition gastric bypass surgery inflammatory bowel diseases that increase calcium absorption taking medications such as diuretics, antiseizure drugs, and calcium-based antacids Recognizing the symptoms and signs of a kidney stone Kidney stones are known to cause severe pain. Symptoms of kidney stones may not occur until the stone begins to move down the ureters. This severe pain is called renal colic. You may have pain on one side of your back or abdomen. In men, pain may radiate to the groin area. The pain of renal colic comes and goes, but can be intense. People with renal colic tend to be restless. Other symptoms of kidney stones can include: blood in the urine (red, pink, or brown urine) vomiting nausea discolored or foul-smelling urine chills fever frequent need to urinate urinating small amounts of urine In the case of a small kidney stone, you may not have any pain or symptoms as the stone passes through your urinary tract. Why kidney stones can be a problem Stones don’t always stay in the kidney. Sometimes they pass from the kidney into the ureters. Ureters are small and delicate, and the stones may be too large to pass smoothly down the ureter to the bladder. Passage of stones down the ureter can cause spasms and irritation of the ureters as they pass. This causes blood to appear in the urine. Sometimes stones block the flow of urine. This is called a urinary obstruction. Urinary obstructions can lead to kidney infection and kidney damage. Testing for and diagnosing kidney stones Diagnosis of kidney stones requires a complete health history assessment and a physical exam. Other tests include: blood tests for calcium, phosphorus, uric acid, and electrolytes blood urea nitrogen (BUN) and creatinine to assess kidney functioning urinalysis to check for crystals, bacteria, blood, and white cells examination of passed stones to determine their type The following tests can rule out obstruction: abdominal X-rays intravenous pyelogram (IVP) retrograde pyelogram ultrasound of the kidney (the preferred study) MRI scan of the abdomen and kidneys abdominal CT scan The contrast dye used in the CT scan and the IVP can affect kidney function. However, in people with normal kidney function, this isn’t a concern. There are some medications that can increase the potential for kidney damage in conjunction with the dye. Make sure your radiologist knows about any medications you’re taking. How kidney stones are treated Treatment is tailored according to the type of stone. Urine can be strained and stones collected for evaluation. Drinking six to eight glasses of water a day increases urine flow. People who are dehydrated or have severe nausea and vomiting may need intravenous fluids. Other treatment options include: Medication Pain relief may require narcotic medications. The presence of infection requires treatment with antibiotics. Other medications include: allopurinol (Zyloprim) for uric acid stones diuretics sodium bicarbonate or sodium citrate phosphorus solutions ibuprofen (Advil) acetaminophen (Tylenol) naproxen sodium (Aleve) Lithotripsy Extracorporeal shock wave lithotripsy uses sound waves to break up large stones so they can more easily pass down the ureters into your bladder. This procedure can be uncomfortable and may require light anesthesia. It can cause bruising on the abdomen and back and bleeding around the kidney and nearby organs. Tunnel surgery (percutaneous nephrolithotomy) Stones are removed through a small incision in your back. This procedure and may be needed when: the stone causes obstruction and infection or is damaging the kidneys the stone has grown too large to pass pain can’t be controlled Ureteroscopy When a stone is stuck in the ureter or bladder, your doctor may use an instrument called a ureteroscope to remove it. A small wire with a camera attached is inserted into the urethra and passed into the bladder. The doctor then uses a small cage to snag the stone and remove it. The stone is then sent to the laboratory for analysis. You can substitute ginger ale, lemon-lime soda, and fruit juice for water to help you increase your fluid intake. If the stones are related to low citrate levels, citrate juices could help prevent the formation of stones. Eating oxalate-rich foods in moderation and reducing your intake of salt and animal proteins can also lower your risk of kidney stones. Your doctor may prescribe medications to help prevent the formation of calcium and uric acid stones. If you’ve had a kidney stone or you’re at risk for a kidney stone, speak with your doctor and discuss the best methods of prevention. Homeopathic medicines for kidney stone are dual action remedies which are natural and safe. First, they help remove the stones present in the urinary tract either by crushing them into fine sand-like particles or in a few cases, in the intact state. Secondly, they hold the promise of completing removing the tendency towards stone formation in the future. While selecting the appropriate Homeopathic medicine for kidney stone, the side affected is considered along with the pain and associated symptoms. The colour of sand particles in urine helps to further refine the search. Although kidney stones can be safely handled with properly selected Homeopathic medicines, care should be taken when the size of the stone is very large and it gets impacted in the ureter leading to hydronephrosis that calls for surgical intervention to prevent kidney damage. Here is a list of the most effective homeopathic medicines for treating kidney stones: Argentum nit: This medicine is used when a patient experiences nephralgia due to kidney congestion or from the passage of calculi. Dull aching is experienced at the back of the bladder and the urine is dark, containing blood and deposits of renal epithelium and uric acid. Urine passes little at a time, usually in drops. The patient’s face becomes dark and dry. The urine burns during passage and the urethra feels like it is swollen. Belladonna: It is used when the kidney stones are accompanied by sharp and shooting pains. Sudden cramps and strains along the ureter during the passing of urine are likely. The patient may feel feverish and excited. Irritation, clutching and cramps are likely to occur as well. Benzoic acid: This homeopathic medicine is used in case of nephritic colic with offensive urine. The urine is deep red in color and has a strong odor. It may smell cadaverous and putrid. The urine is thick and water like clear in an alternative way. The patient usually feels better when the urine is thick and profuse. Berberis: This is another effective homeopathic medicine for kidney stones. It is used when there is shooting pain radiating from a point. The patient may be unable to move or even sit on his painful side. The pain may run up to the kidneys or down to the bladder as well. Little calculi with pin heads may develop in the pelvis. Berberis is efficient in giving relief to such pain. The patient may also experience burning and soreness in the kidney along with severe distress. The urine is dark and turbid in nature with copious sediment and urine flow becomes slow. There is an increased urge for urinationDr. Rajesh Gupta16 Likes18 Answers
- Login to View the image
RENAL CALCULUS Stones that form in the kidneys and can be as tiny as a speck of dust, or as big as the size of a tennis ball. Apart from the kidneys, the stones can also form anywhere along the urinary tract which includes the ureter, bladder, and urethra. What are the causes of kidney stones or how do kidney stones occur? After your body absorbs the nutrition it needs, the remaining waste products travel through the bloodstream to the kidneys. The waste products get removed from your body through urine. When there is too much of waste and too less liquid in the urine, crystals begin to form which stick together and form solid masses or kidney stones. The reasons of kidney stones forming in the body varies. There are four main types of kidney stones: Calcium Stones: Calcium stones are the most common form of kidney stones. They are formed when there is too much calcium in the urine. Struvite Stones: These are horn-shaped and can grow quite large. They are usually caused by urinary tract infection. Uric Acid Stones: Uric acid stones are softer than other types of kidney stones. They may occur due to a high-protein low-fibre diet. Cystine Stones: They are caused by a rare hereditary disorder called cystinuria. Cystine stones are larger than other forms of kidney stones and tend to recur. In about 85% of the cases, small kidney stones (<5 mm) pass out in the urine without medical intervention. Stones bigger than 5 mm may require medical intervention. Stones as small as 2 mm have been know to cause discomforting symptoms. If you experience any of the aforementioned symptoms of kidney stones, you should immediately consult your family doctor or a general physician, who in turn may refer you to a urologist if a kidney stone is suspected. Who is prone to kidney stones? Some people are at a higher risk of developing kidney stones. They include: people who do not drink enough water everyday (around 8 glasses per day) people with a family history of kidney stones people bed-bound due to illness people who lead a sedentary lifestyle people suffering from obesity people suffering from frequent urinary and kidney infections people who eat a high-protein diet and low-fibre diet people who consume of excessive sodium (salt) people with active medical conditions such as Crohn's disease , gout, renal tubular acidosis, hyperparathyroidism, medullary sponge kidney, type 2 diabetes, and Dent's disease people who excessively consume supplements such as calcium and vitamin C What are the symptoms of kidney stones? How are kidney stones diagnosed? The common symptoms of kidney stones in men and women include: Foul smelling urine Discoloured urine: pink, red, brown urine or blood in the urine Frequent and urgent need to urinate Fever and chills Nausea and vomiting Shifting pain in the lower abdomen and groin Varying intensity of pain that comes and goes Diagnosis tests may include: 1)computerised tomography (CT) scan: where computerized low-intensity X-Ray images are taken from different angles and analysed. 2)X-ray: which uses a low dose of electromagnetic radiation to accurately create images of the internal structures of your body. Radiolucent stones such as Cystine or uric acid stones may not be identified with this test. 3)Ultrasound scan: Images of the internal structures of your body are recreated using high-frequency sound waves. 4)Intravenous urogram (IVU) or intravenous pyelogram (IVP): In this procedure, a radio-opaque dye is injected through a vein in your arm. This dye highlights the presence of the stones on an X-ray. The dye later passes out of your body in the urine. 5) MRI What are the complications of kidney stones? Complications of kidney stones include: recurring kidney stones, since people who have had kidney stones at least once, have 80 % chance of getting them again. obstruction or blockage in the urinary tract kidney failure sepsis, which can occur after the treatment of a large kidney stone an injury to the ureter while undergoing a surgery for the removal of the kidney stone urinary tract infection severe pain heavy bleeding during kidney stones operation Homoeopathic medicines:- Bereberis vul. Ocimum can. Lycopodium Chin. Sulph. Sarsaparilla Pareira B. Calcarea Carb. Urticaria Urens Natrum Phos. Terebinthina Belladonna Dioscorea Cantharis Hydrangea Arbores Millefolium Causticum Dr.Sangeeta kumariDr. Sangeeta Kumari11 Likes10 Answers
- Login to View the image
HYPERPARATHYROIDISM. The parathyroid glands are responsible for maintaining the extracellular calcium concentration . Hyperparathyroidism is a disease characterised by excessive secretion of parathyroid hormone,an 84 -amino acid polypeptide hormone. The main effects of parathyroid hormone are to increase the concentration of plasma calcium by *Increasing the release of calcium and phosphorus from the bone matrix. *Increasing calcium reabsorption by the kidneys. *Increasing renal production of 1,25-dihydroxy vitamin D3 (calcitriol ) which increases intestinal absorption of calcium. ANATOMY. Usually four parathyroids are situated posterior to the Thyroid gland.They are right and left superior and inferior glands. The inferior glands are derived from third pharyngeal pouch and migrate down. The superior glands are derived from fourth pharyngeal pouch and usually found just superior to the intersection of the inferior thyroid artery and recurrent laryngeal nerve. There are three types of hyperparathyroidism. Primary hyperparathyroidism. Secondary hyperparathyroidism. Tertiary hyperparathyroidism. PRIMARY HYPERPARATHYROIDISM. Primary hyperparathyroidism is unregulated overproduction of parathyroid hormone (PTH ) resulting in abnormal calcium homeostasis. The mean age at diagnosis is 52 -56 years. Female -to -male ratio is 3 :1. CAUSE. 85 % of cases -caused by single adenoma. 15 % of cases - caused by multiple adenomas or hyperplasia. Rarely,it is caused by parathyroid carcinoma. Familial cases can occur due to multiple endocrine neoplasia syndromes. , Hyperparathyroid - jaw tumour syndrome Familial isolated hyperparathyroidism (FIHPT ) PATHOPHYSIOLOGY. The chronic excessive resorption of calcium from bone due to excessive PTH can result in Osteopenia. Osteitis fibrosa cystica. Sub periosteal resorption of distal phalanges. Tapering of distal clavicles. Salt and pepper appearance of the skull. Brown tumours of the long bones. Other symptoms of hyperparathyroidism are. THE SYMPTOMATOLOGY OF HYPERPARATHYROIDISM ARE RENAL STONES. PAINFUL BONES. ABDOMINAL GROANS. PSYCHIC MOANS. OTHER SYMPTOMS OF HYPERPARATHYROIDISM. They are due to hypercalcemia.They are Muscle weakness. Fatigue. Volume depletion. Nausea and vomiting. Coma and death. Neuropsychiatric manifestations like depression and confusion. Peptic ulcer disease and pancreatitis. CLINICAL PRESENTATION. BONES,STONES,ABDOMINAL GROANS AND PSYCHIC MOANS. SKELETAL MANIFESTATIONS. Osteitis fibrosa cystica characterised by increased generalized bone resorption,particularly involving the phalanges causing subperiosteal resorption,and skull gives radiological appearance of salt and pepper skull. Renal manifestations are polyuria,kidney stones,hypercalcuria and nephrocalcinosis. Gastrointestinal manifestations are anorexia,nausea , vomiting,abdominal pain,constipation,peptic ulcer disease and pancreatitis. Neuromuscular and psychological manifestations are proximal myopathy,weakness,easy fatigability,depression,inability to concentrate and memory problems. Cardiovascular manifestations are hypertension,bradycardia,shortened QT interval,and left ventricular hypertrophy. PHYSICAL EXAMINATION FINDINGS ARE USUALLY NON CONTRIBUTORY. LABORATORY STUDIES. TESTING OF INTACT PARATHYROID HORMONE IS THE CORE OF THE DIAGNOSIS.AN ELEVATED INTACT PARATHYROID HORMONE WITH AN ELEVATED IONISED SERUM CALCIUM LEVEL IS DIAGNOSTIC OF PRIMARY HYPERPARATHYROIDISM. A 24 HOUR URINARY CALCIUM MEASUREMENT IS ESSENTIAL TO RULE OUT FAMILIAL HYPOCALCIURIC HYPERCALCEMIA. ULTRASOUND of the neck is a safe procedure for localization of abnormal parathyroid glands. NUCLEAR MEDICINE SCANNING WITH RADIOLABELLED SESTAMIBI is used to detect abnormal parathyroid tissues in which the radionuclide concentrates. 4D - CT SCAN AND MRI are also used to locate abnormal parathyroid glands. TREATMENT. SURGICAL EXCISION OF ABNORMAL PARATHYROID GLANDS IS THE ONLY PERMANENT,CURATIVE TREATMENT FOR PRIMARY HYPERPARATHYROIDISM. Surgical treatment is offered to all patients with symptomatic disease.The indications for surgery are *One mg /dl above the upper limit of reference range for serum calcium. *24 hour urinary calcium excretion is >> 400 mg. *A 30 %reduction in creatinine clearance. *Bone mineral density T score <<2.5. *Age << 50 years. Patients with asymptomatic hyperparathyroidism are monitored with serum calcium,serum creatinine and annual bone mineral density. Other management measures are. Moderate daily elemental calcium intake of 1000 mg Vitamin D intake. Maintain good hydration. Regular exercise. Avoidance of immobilisation. Avoid medications like thiazides,diuretics and lithium. Treatment with BIPHOSPHONATES - ALENDRONATE ,has been shown to improve BMD SECONDARY HYPERPARATHYROIDISM. Secondary hyperparathyroidism is the overproduction of parathyroid hormone secondary to a chronic abnormal stimulus for its production. Most common cause is CHRONIC RENAL FAILURE. Other causes are. Vitamin D deficiency. LABORATORY STUDIES. Serum level of parathyroid hormone,calcium,phosphorus and 25 - hydroxy vitamin D are measured. Parathyroid hormone -elevated. Calcium -low normal calcium. Phosphorus -high in renal insufficiency. - low in vitamin D deficiency. Vitamin D -Normal ->>> 30 ng /ml. - mild deficiency 21 - 29 ng /ml. -deficiency <<< 20 ng / ml. TREATMENT. Unlike primary hyperparathyroidism,MEDICAL MANAGEMENT IS THE MAINSTAY OF TREATMENT FOR SECONDARY HYPERPARATHYROIDISM. Correcting vitamin D deficiency. Dietary phosphate restricted. Phosphate binders are used. Calcium supplementation <<2 g/d TERTIARY HYPERPARATHYROIDISM. This is a state of excessive secretion of parathyroid hormone after long standing secondary hyperparathyroidism and resulting in hypercalcemia. Finally one word. Primary hyperparathyroidism. Calcium increased. PTH increased. Urine calcium increased. Phosphate reduced. Secondary hyperparathyroidism. Calcium reduced. PTH increased. Tertiary hyperparathyroidism. Calcium increased. PTH increased.Dr. Suvarchala Pratap18 Likes10 Answers
50y/f c/o dysuria with burning sensation previously blood urea and s.creat was 73 and 4.8 respectively after a week BUrea and Screat is 80 and 4.2 urine pus cell 40-45 pt was on a/b tamsulosin bid and pain killer kindly suggest how to manage.Dr. Mandeep Sharma0 Like2 Answers