This lady with bilateral small size renal stone and urinary infection should be quite easy to manage,must do culture and sensitivity of urine to eradicate the infection, once the infection Is clear ,three Negative cultures should be carried out before concluding treatment for infection. Treating urinary infection on the basis of presence of pus cells is greatly flawed and only causes resistance growth of bacteria due to repeated prescription of different antibiotics. Renal pain should be managed By IV inj. Of a mixture of diclofenac and Buscopan Da the time of renal colic ,and pt . Instructed to go on plenty of fluids. I have seen cases of upto 8 to 10 mm stones evacuated spontaneously without any surgery or any other intervention ,pt being able to lead normal life.
A case of Bilateral nephrolithiasis Needs evaluation as to the cause of nephrolithiasis. Get S. Uric acid , s.calcium, phosphorus done . Get a urine culture and sensitivity done and give antibiotics for prolonged period. Best is nitrofurantoin which has got least resistance. . Right now give her symptomatic treatment with antispasmodics, plenty of oral fluids, potrate MB6 3tsf in a glass of water twice a day, As there is no hydronephrosis surgery can be avoided at this time . Plenty of Ayurvedic preparations are available like Neeri , Warstone , cystone etc which can be effective. In persistent UTI - Tab Utioff - containing cranberry extract and D- mannose can be given for 3 months
Renal colic may be due to calculi or infection or spasam send urine for routine & culture & sensitivity cataspa TDs zintec 150 TDs lasilactone half od sy protrate MB 6 10 ml TDs in water iv glucose bolus of lasix homoeopathy 30 potency berberis vulgaris & sarsaparilla chew TDs repeat usg after 2 months plenty of fluid if passes stone then do stone analysis for proper treatment generally renal stone is silent avoid rough road
Very good morning Doctor..... you can prescribe her Tab.Nitrofurantoin 100 mg bid for 15 days....Urikind KM sachet in one glass of water in alternative days 3....Syp.Cital UTI 10 ml TID .....and for flank pain .... you can prescribeDrotavarine HCl tab for 20 days in bid dose.....and also tab.Urimax 0.4 during night time....ask her to take plenty of water.. coconut water....
She is known case of renal stones Now she is presenting with right flank pain With burning micturation It is likely that one stone has come in right ureter causing right renal colic with urinary tract infection Please repeat USG KUB, urine routine and culture, CBC plan Uretero reno scopy for treatment of ureteric stone if documented
Repeat USG abdomen...starts drinking Plenty of water daily...start tab.cystone....BD for 15 days...again repeat USG if the size is not subsided...then opinion of the nephrologist...who will advice u to do endoscopic removal of the stone..by breaking it into particals and putting dj stent in ur urinary tract.
Adv----KUB. Rt kidney stone 5.5 mm size,,Lt kidney 6.5 mm size,,Nephrolithiasis. WBC(8-10). Rx. Tab Cefuroxim 250 mg bd,,Tab Meftalspas+ Dynapar.,Tab Aciloc RD,,Tab Cystone bd,,Neeri syp 10 ml bd,,Berri-Berri drop(Homeopathic) 10 drop in half cup of water. bd. Intake plenty more Water.
Stones are up in kidney.. No hydronephrosis Stone size is smaller Hence..conservative Analgesics Oral fluids up to 4 lots a day provided creatinine is normal. If stone z stuck in utter can go for URSL for ESWL stone should be at least 8mm...
sir this is the yesterday's Usg plz suggest some more the patient also got appendectomy before 13 yr ago now a general physician again told him that there reinfection in appendix is that possible ? .the also feel pain at Mc brne point
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58Y/M. CAME TO MY OPD WITH COMPLAINTS OF SEVERE LEFT SIDE LOIN PAIN WITH VOMITING, ,H/O -GASTRITIS, ,,NO FEVER, ,LM, ,NO BURNING IN URINE, ,TPR /BP --WNL, ,BELOW IS THE SCAN OF (A+P),,,SO DEAR CUROFIANS PLZZ GIVE UR OPINION REGARDING THIS, ,THANKS, ,REGARDS, ,DR RAJ PANDEY MISHRADr. Raj Pandey Mishra3 Likes7 Answers
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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 Gupta17 Likes18 Answers
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a38 yr old male pt c/o abdominal pain since 3 day h/o constipation since 2 day USG s/o left kidney small right sided hydronephrosis renal stone creat is 4.5 kindly suggest management and dxDr. Azeem Sarwar2 Likes7 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
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Pat.20 Yr. Girls wt 26 Kg.. mild fever .. pain at both loin to groin region mild to sever ..pain mostly at right side so what is line of treatment for multiple stone .. medical or surgical... plz ..ur adviceDr. Paighan Subhash1 Like21 Answers