Aims and Scope
Porosity in Microtomography and Determination of Hounsfield Units do not Predict Calculi Fragmentation in Extracorporeal Lithotripsy: Analysis of an In-vitro StudyRafael Cavalheiro Cavalli, Mateus Cosentino Bellote, Mauricio Carvalho
Extracorporeal Shock Wave Lithotripsy (SWL) remains one of the most popular methods for treating urinary lithiasis.
To evaluate structural and microtomographic characteristics associated with urinary calculi fragmentation in an experimental model of SWL.
Samples consisting of at least two calculi fragments obtained from patients were submitted to urological procedures. All calculi were analyzed by X-ray diffraction and a morphological evaluation (weight, length, width, and volume measurements) was conducted along with microtomographic and conventional tomographic assessments in vitro. Thereafter, each sample was submitted to SWL in a ballistic gelatin model. The fragments were separated, using a granulometric sieve, into specimens larger than 4 mm and 2 mm, which were subsequently weighed.
Altogether, 48 urinary calculi were analyzed and were composed of whewellite (54%), struvite (22%), apatite (11%), uric acid (7%), cystine (4%), and whitlockite (2%). The fragmentation rate was 77.5% and 69.6% for samples > 4 mm and > 2 mm in size, respectively. Factors associated with a reduction in the effectiveness of SWL were volume, dry mass, and width of the calculus. The radiodensity and porosity of the samples evaluated by microtomography were not associated with the fragmentation of calculi.
The volume, dry mass, and width of urinary calculi were positively correlated with the number of fragments larger than 4 and 2 mm in size obtained post-SWL.
December 18, 2020
- July 31, 2020
- May 23, 2020
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- October 16, 2020
Prevalence of Chronic Kidney Disease and Its Determinants in Rural Pondicherry, India-A Community Based Cross-Sectional StudyRavi Kumar P, Amol Dongre, R. Muruganandham, Pradeep Deshmukh, D. Rajagovindan
The burden of CKD is on the rise globally and in India. There are scarce population based studies based in rural industrialized settings in India and elsewhere.
To find out the prevalence and determinants of Chronic Kidney Disease (CKD) among adults in rural Pondicherry, India
It was a community-based cross-sectional study in 13 villages of a Primary Health Centre in rural Pondicherry. A representative sample of 422 adults more than or equal to 50 years of both genders was selected by population proportional to size methods. All the participants were screened by SCORED questionnaire to get the potential cases of CKD. We did serum creatinine, urine examination, blood pressure and anthropometric measurement for the potential cases. CKD was diagnosed by estimation of glomerular filtration rate and presence of protienuria. The data was analyzed using Statistical Package for Social Science version 24. The study was approved by the Institutional Ethics Committee of SMCMCH, Pondicherry.
The prevalence of CKD was found to be 24.2% in the study sample of respondents 50 years or more. Most (73.5%) of the CKD cases were at stage 2, Stage 3a had 15% and stage 3b had 2% of the cases. The determinants of CKD were (60-69 years, PR: 2.36,CI:1.36-4.07), poor nutrition(underweight, overweight and obesity)poor nutritional status (underweight:PR: 2.26,CI:1.05-4.89), (overweight:PR: 2.19,CI:1.06-4.52), (obese:PR: 2.13 CI: 1.13-4.01) and presence of at least one chronic co-morbidity(PR:5.85,CI:1.38-24.78). Majority of the patients in the CKD group had minimal proteinuria 87.25%. And 42.15% of the CKD group had no diabetes mellitus or hypertension.
Conclusion and Recommendation:
Considering the higher prevalence of CKD in the study area, targeted screening of adult population should be undertaken as means of early detection, diagnosis, treatment and follow up of at-risk individuals to prevent further progression of CKD. Further research is required to look at the aetiology of CKD.
June 30, 2019
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