Ammonia and the Haber Process

Ammonia (NH3) is a covalent compound and is an extremely useful chemical. It is commonly used to make: nitrogenous fertilisers which is very important in agriculture household cleaning agents such as glass window cleaners, floor cleaners, etc explosives for demolishing buildings and structures Ammonia is manufactured industrially by the Haber Process. We will take a look at the details on this important industrial process later in the blog post. To learn this topic effectively, we shall structure our discussion into 3 parts, namely: Part 1: Reversible Reactions Part 2: Manufacturing of Ammonia by the Haber Process Part 3: Displacement of Ammonia from Ammonium Salts Part 1: Reversible Reactions Many chemical reactions can proceed in one direction only. i.e. they cannot be reversed and they go towards completion. These are known as irreversible reactions. e.g. Neutralisation reaction between acid and alkali KOH(aq) + HCl(aq) → KCl(aq) + H2O(l) e.g. Combustion reaction 2Mg(s) + O2(g) → 2MgO(s) However, some chemical reactions can be reversible. i.e. reactions can go either directions and they reached an equilibrium, instead of going towards completion. These are known as reversible reactions. At equilibrium, the forward and backward reactions do not stop; they continue, but at the same speed. Hence, there is no overall change in the amounts of reactants and products. A mixture of reactants and products is present and they are known to be in equilibrium. A double arrow sign, ⇌  is used to indicate a reversible reaction. Forward reaction refers to the reaction going from left to right. Backward (or reverse) reaction refers to the reaction going from right to left. e.g. Thermal decomposition of ammonium chloride, NH4Cl(s). In fact, this is a reversible reaction and is represented by the following equation NH4Cl(s) ⇌   NH3(g) + HCl(g) Upon heating , solid ammonium chloride decomposes to form ammonia gas and hydrogen chloride gas. Forward reaction: NH4Cl(s) → NH3(g) + HCl(g) Upon cooling, solid ammonium chloride is formed back. Backward reaction: NH3(g) + HCl(g) → NH4Cl(s) There are many other examples of reversible reactions. The reaction between nitrogen and hydrogen to form ammonia is another example of a reversible reaction which will be tested in both the GCE O-Level Pure Chemistry Exam as well as IP Year 4 Chemistry Exam. Part 2: Manufacturing of Ammonia by the Haber Process Ammonia is manufactured industrially by the Haber Process. The raw materials for the Haber Process are nitrogen gas and hydrogen gas. Raw Materials: N2(g) is obtained from the Fractional Distillation of liquefied air H2(g) is obtained from the Cracking of crude oil (petroleum) Equation:                           N2(g) + 3H2(g) ⇌ 2NH3(g)                     ∆H = -ve In reversible reactions, the forward and reverse reactions occur simultaneously. Forward Reaction:        N2(g)  +  3H2(g) → 2NH3(g) Backward Reaction:     2NH3(g) → N2(g)  +  3H2(g) Since the reaction is reversible, thus to have a good yield (amount) of ammonia gas, reaction conditions (temperature, pressure and the use of catalysts) are carefully controlled. Conditions: The nitrogen and hydrogen molecules are generally unreactive and thus there are no reaction between the two gases are room temperature and pressure. For the two unreactive gases to react together, a high pressure and relatively high temperature are required. Finely divided iron catalyst is also needed to speed up the chemical reaction. As we have discussed earlier, the reaction is reversible i.e. some of the ammonia molecules formed will decompose back to become nitrogen and hydrogen molecules. As such, reaction conditions (temperature and pressure) are carefully controlled by chemists and chemical engineers to ensure maximum yield of the product (ammonia gas) at a minimum cost. 1) Effect of Temperature The lower the temperature, the higher will be the yield of ammonia, since the decomposition of ammonia back to hydrogen and nitrogen will be reduced. Lower temperature, however, will also results in a slower rate of reaction. Therefore, there is an optimal temperature that is being used. 2) Effect of Pressure The higher the pressure, the higher will be the yield of ammonia. Higher pressure will also increases the rate of reaction. However, high pressure condition will be dangerous for people working in the manufacturing plant. More expensive equipments must be used to maintain high pressure. Therefore, there is a limit to the amount of pressure that can be used. 3) Effect of Catalyst Despite the high pressure and relatively high temperatures being used, the rate of reaction is still quite slow. Therefore, a suitable catalyst is being used to speed up the rate of reaction. Optimal Conditions in the Haber Process: The best conditions used in the industry for obtaining the maximum yield of ammonia at minimum cost are: Pressure of 200 atm Temperature of 450 oC Presence of a finely divided iron catalyst Note: For students based in Singapore, do note that slightly different values have been quoted for the optimum pressure of the Haber Process, in both the two different Ministry of Education (MOE) approved Chemistry textbooks. Pearson’s O-Level All About Chemistry reference textbook (2019 Edition) quoted 200 atm. Marshall Cavendish’s O-Level Chemistry Matters reference textbook (2019 Edition) quoted 250 atm. Schools will take reference from the approved textbooks so you will see that different GCE O-Level Pure Chemistry and IP Chemistry schools will use either one or the other values. Both are equally acceptable since there is a range of pressures (atm) which is being used industrially. % Yield Graph The following % Yield Graph might be given in your upcoming O-Level Pure Chemistry exam or IP Chemistry exam. Note that you might even be asked to draw a simple graph to see how % Yield of ammonia is related to Temperature and Pressure. Details in the Haber Process 1.Nitrogen and hydrogen are mixed in the ratio of 1:3 by volume 2.Mixture of gases is compressed to 200 atm and heated to 450 oC 3.Mixture of gases are passed over finely divided iron catalyst 4.Reaction is exothermic 5.Only about 10-15% of nitrogen is converted to ammonia i.e. % yield = 10-15% 6.A mixture of nitrogen, hydrogen and ammonia is obtained in the converter 7.Mixture of gases are then cooled in the cooling chamber (condenser) 8.Ammonia gas condenses to become liquid ammonia while hydrogen and nitrogen remains as gases 9.Unreacted hydrogen and nitrogen are pumped back (recycled) into the converter for further reaction. Part 3: Displacement of Ammonia from Ammonium Salts Ammonia can also be prepared in the Chemistry laboratory. When an ammonium salt is heated with a strong alkali such as sodium hydroxide, potassium hydroxide and calcium hydroxide, ammonia gas is being displaced from the salt. Ammonium Salt + Strong Alkali → Salt + Water + Ammonia e.g. NH4Cl(aq) + NaOH(aq) → NaCl(aq) + H2O(l) + NH3(g) Loss of Nitrogen from Fertilisers in Agriculture Calcium hydroxide and calcium oxide (quicklime) are widely used in agriculture to neutralise excess acidity in soil. However, both calcium hydroxide and calcium oxide will react with nitrogen fertilisers to form ammonia gas, which then escapes into the atmosphere. e.g. 2NH4Cl(aq) + Ca(OH)2(aq) → CaCl2(aq) + 2H2O(l) + 2NH3(g) This causes the loss of nitrogen from fertilisers already added to the soil by farmers. Thus, nitrogenous fertilisers and calcium hydroxide / calcium oxide should not be added to soil at the same time.

Qualities of an Ideal Teacher

Qualities of an Ideal Teacher

A good teacher is he who teaches the students how to lead their lives controlled and cleanly to achieve knowledge and skills. A good teacher is vitally significant for effective teaching to the students in systematic manner. He should know the precise way of teaching where the students are stimulated to learn and devote themselves to study. A good teacher is an architect for edifice a good native in the country.

Key words: doppelgänger, knowledge, visual, basic, precise, architect, native

“Learners love me, I love my lovers,

Searchers look me in unseen sheet of papers,

I am knowledge. "

There is no denying the fact that Teaching is the effective transfer of appropriate behaviours between the teachers and the students which lead to the achievement of predetermined and specified results'. Hence in order to demonstrate the purpose of teaching that is the transfer of knowledge to the students accurately so that after receiving teachings they can acquire projected knowledge and predetermined fallouts. Hence a good teacher is he who teaches the students how to lead their lives controlled and cleanly to achieve knowledge. A good teacher is vitally significant for epitome teachings to the students as a tentative flow. He should know the precise way of teaching where the students are stimulated to learn and devote themselves to study. A good teacher is an architect for edifice a good citizen in the country.

Suffice it to say that in order to make teaching effective, the three things are crucially imperative. These are Good teacher, Good method and Good books. Undeniably, a good teacher plays a vigorous role in making teachings to the students efficacious. Being a teacher, he should perform in such a way by virtue of his own doppelgänger, voice and body use so that interface and transferral of behaviour between the teacher and the student are accelerated in a systematic manner.

About the doppelgänger, he needs to act like the following:

& Well-dressed

& Well rested

& He has to arrive before the students

& He has to greet the students as they arrive

& He needs to be  enthusiastic about teaching in relevant field

& He has to  identify and help the less able students

& He should remain alert and concentrate on how his students are behaving

& He should be an attentive listener

& He should think before he speaks

& He should not be restless

& He should have meaningful learning experience.

Assuming in a teaching classroom, computer class on Oracle Programming class  is going on. The students are feeling tedious because the teacher was not well dressed and well rested. Rather he has attained late and he has not welcomed them. Some students do not comprehend his lecture. He is running fast. He is not identifying and helping the less able students. In this case, in spite of his sound knowledge in the relevant field, he may not be treated as a good teacher. Besides this, in order to make our teachings impressive by good grounding, we need to follow as appended below as regards the  use of Voice:

& A teacher must start with Bang and end with Bang. Here Bang refers to a good beginning and an impressive finishing.

& In between check and interaction, a teacher should understand one thing that the students are learning.

& To plan for accurate timing

& To choose a suitable teaching methods in respect of the students and topics with a great care. And to help the students learn, especially those who are with problems.

An ideal teacher needs to play a vital role in active advisor among the students. He needs to be careful about the criteria on Control, Guide, Consult and Facilitate.

& Control: To draw up and issue instruction, and stay with the students, closely supervising its action.

& Guide to clarify what is required, hand over ownership to students and offer to give advice when they call you.

& Consult: To give a broad outline, ask students to discuss ideas and agree actions, using us as a separate expert reference point.

& Facilitate to give overall direction, co-ordinate the group's discussion and expect it to produce a progress report.

Being a teacher, we need to be very careful in using our voice for effective teaching class. A good teacher need not be enthusiastic and agitated towards the students. We should give chance to ask question to the students so that transfer of behaviour is made possible in a significant manner. Sometimes, we forget that we are a teacher and we have a particular job for the students on the concept of learning. According to Franchise Bacon, there are two types of learning: One is Pedagogy- children's learning and the other is Andragoggy- Adult learning. In case of adult learning, we cannot teach anybody, we only help him or her to learn. So in the case of using our voice we need to be responsible and tactful. Hence Somerset Maugham says " It is difficult to pass over the razor's edge, but the wise say the path to salvation is hard "

An ideal teacher needs to be well conversant about using the language. It is indispensable to create awareness and congenial atmosphere on the part of a teacher. In order to develop lecture, group discussion is a vital thing. As a teacher, we have to ensure that group performance is effective.

Apropos to the teaching method, the following are important to apply in teaching the students virtually.

1.      Telling is not teaching

2.      Age is not a bar to learn

3.      Meaningful learning experience

4.      Voice, image and body use

5.      Practically oriented way of teaching

6.      Repeat, Recap and Review

In view of the above, a good teacher selects any method to teach the students but most of the good teachers select the sixth Rule of teaching that is ' Repeat, Recap, Review ' which is the most important one to make the teaching vitally effective, meaningful, fruitful and up to the mark

     The reasons in support of the argument are stated as follows.

(a)   Repeat: According to Franchise Bacon, 'when you tell something in the class to a group of students, it is only a saying but when you recapitulate it, repeat it and ask the question on the progress, it will be interacted and if you further emphasize the concept, they will be conversant with the relevant knowledge'. Indeed, incase of delivering an important message, if it is stated once-only 10% will be memorized but if it is stated 6 times then 90% are memorized after one year.  So, reiteration/repetition is the most important tools for the teaching to make the topics rememberable. If the message is not remembered and understandable then the whole thing will be treated as useless.

(b) Recap: It is generally meant by recap to go over again the vital point of  the relevant contents. Using FULLE-R and VHF for better memorization can do the recap. As the first events are best memorized so to start with big message. Thereafter unusual event like cartoon, exercise etc. be used. Thirdly, linked event, here mnemonics or analogy can be used and lastly to end with big messages of fascination towards the topics. In this context, summing up the ideas to arrive the conclusion that is the gist in question to be communicated to the students as a good communicator of the teaching course. We should remember one thing that ' Telling is not teaching; we need to make teaching active and interesting; get students involved;  see it from the student's view; we should use VHF and FULL-R. According to Comoneus, a famous educationist, for an effective teaching, 'only lecture is immaterial but in order to ornament it for better memorization, ideal approach, demonstration, visual display and varieties of attractions of the students are needed'

(b)   Review: A proverb always goes like ' To err is human'. It is human nature to forget the things/message, which is not reviewed that are we losing what we don't review. To review we are to regularly sum up where we have reached and invited questions. At the end  of every topics if the teacher repeats, recap and review, ask questions and help them to answer properly, the students will be more motivated and conversant with the subjects and grasp it properly so that teaching will be effective and fruitful. That is to say, a teacher's behaviour will be in such, which must attract the students for effective and efficient teaching.

In delivering lecture, there are limitations, which may create interference to learning on the part of the students. Sometimes the lecture may be droning due to constant saying. If there exists waterlessness amongst the students, the teacher should change the policy of his lecture. He should ask open-ended questions. Open ended question help get students involved. Assuming to know a particular thing, one may get interested if he is intended to know those particular items. An ideal teacher needs to be well conversant about using the language. It is indispensable to create awareness and congenial atmosphere on the part of a teacher.  Otherwise,  we have to live in the midst of frustration and unlawful activities where there will be no light of education as a symbol of blaze illumination and tranquility of life. In this context, William Shakespeare says:

" Out! Out! A brief candle,

A life's but a walking shadow,

A poor player!

That struts and frets his hour

Upon the stage!

And then is heard no more,

It is a tale;

Told by an idiot,

It is full of sound and fury;

Signifying nothing."

Our Prophet

There is no denying the fact that the great men who have dedicated through out their lives for the cause of salvation of humanity as well as for Muslims solidarity and who have tried their supreme effort to establish peace and principles of truth in the hereinafter, out of them Mohammad(SM) was the greatest and as per history of the world he had struggled for the truth universally recognized and bestowed by God upon human beings. He had been come down to this ephemeral world with a message of salvation of humanity who was enchained by evils, corruptions and anarchism. God had sent him to the people of this earth as a clear direction of truth, divinity and justice. God had written Quaran as a complete code of all Muslim Ummah specifically for those who are down trodden, sufferer, victimized and poor. Michael Hart was a great author who has written a book named “The Hundred” which is bedded upon hundred most influential persons of the world since the creation of the earth. That is to say, the influential persons have come down to the ephemeral world with a definitive purpose to flourish light of education in respect of both spiritual and institutional on earth as a tentative flow. Out of the hundred personalities Mohammad(SM) has been placed on the top, as he was the most influential and spiritual leader through out the world at that time. After placing his name on the top, the Christians communities and the people of other religions were rent and rave the circulation of the book. Later Hart explicated that, since the creation of human beings, till date, Mohammad(SM) was the influential person in the sense that from the life of a shepherd, he had promoted his life to prophet hood by virtue of his spiritual power and utmost faith upon almighty Allah. He was such a shining star in Islamic World, which upheld the maxim of messages of the holy Quaran, which had been bestowing upon him. Hart also said that he was proud of placing this name on the top because he said that he had done the right thing by doing so. According to him, as a writer it was his duty to express the truth before those who are curious, ignorant and inquisitive to know the unknown.

Mohammad (SM) was the greatest prophet of all time. He was born in a famous Quarieesh tribe. Before his birth, his father Abdullah had died and at the age of six, his mother died. Later, his uncle Abu Talib and his grand father Abu Motalib had brought up this orphan child. In the history of mankind, these two figures have been reflected in the Muslim world with supreme reverence and sanctity. Mohammad (SM) was the symbol of self-help and he spent most of his childhood by advising the people for being self-reliance based on full faith on Islam. His foster mother Halima had brother had brought up him from his very early days. She had observed very rare qualities in him and she, with a great heart began to bring him up with due solemnity and praise. His uncle, Abu Talib was a business man and in relation to trade and commerce, he started for Syria. On his way he came across Buhaiya, a veteran demonstrator of Christian religion having talked with Mohammad(SM) he had been pleased and predicted that he had preserved every qualities of the prophet and he had been sent to this world as the blessings of this universe. While the sheep were grazing under his control as a shepherd boy, his heart had been rendered and washed under the miracle incident made by the angels as set forth by Almighty Allah.Afterwards, he had farmed as a promising man of God ‘Hilful- Fazal’ The people at that time in the desert land in the dark Arabia had kept faith upon him in order to lead the youth in a peaceful manner. The object of such promise was to help mankind by way of religion and leading them to control. The social people loved him and got acquaintance of ‘Al-Amin’ which means trustworthy. That is to say, the people of Mecca at that time had scarcity of faith among themselves, so they had developed faith with Mohammad having seen the activities of Mohammad based on spiritualistic behaviour linked with Allah directly, specifically when they kept their goods preserved to Mohammad, took it under his control and returned it at the response of them. Thus, the people of Mecca used to get acquaintance of great heart and thus a faith among them had been developed by degrees. At that time, the people of Mecca were filled with distrust, ignorance and they were involved in various prejudices and believed in a variety of gods and goddess, meaning that they used to worship idols. In the year 595, he took part in trading with Khadija and within a short span of time, she earned lots of profit in her business, she got the identity of a true heart like Mohammad(SM). She was a wealthy lady at that time and by way of achieving the identity of a great personality like Mohammad (SM), she proposed to him for marriage. He told her that he would marry her under one condition- she had to bestow her wealth and fortune for the sake of Islam on the promise to live like the poor, the way he himself lives . Khadeja, having heard such proposal agreed to such condition and they got married. At that time, his age was 25, and she was 40.

After their marriage, an epidemic had taken place in the country that time. Mohammad(SM) had distributed all the resources he had possessed from Khadeja in order to remove the adversity of the people. At that time, the thought of sacrifice for the good of the people were intensified and he was influenced for devotion towards almighty Allah day by day. Apart from Mecca three miles away, in the cave of Hera, he was absorbed in deep meditation of almighty Allah. Such process of supplication continued for forty years. One day, during his meditation, the angel Jibrail (AM) came unto him and said,” Oh! Mohammad, you are the rusul of Allah, you have been sent by Allah”. And thereafter, a message of Allah came, “Read in the name of your lord, from this day onward, in the cave of Here, Mohammad (SM) used to receive messages from Allah through massager, Jibrail (AM), he got accurately and complete message of the holy Quran, with his unquestionable, the ultimate and the complete code of life. In order to convey the message of peace and solidarity, he had struggled through out his life. The non-Muslim troubled in many ways, they threw stones at him, spat at him, beat him and cursed him. He was tormented in various ways, he would tolerate all the misdeeds of the people, his sole message was,” Those people who have unknowingly behaved with me in such a manner, I pray for them to Allah for salvation and forgiveness. The holy Quran has come down to this world with full codes, ethics and directions of Allah. Muhammad (SM) had achieved such messages from Allah directly and it is a recognizing phenomenon that the holy Quaran is completely bedded on super human creation.

Suffice it to say that presently in contemporary age, the researchers with a multiplicity of educational and theological wellbeing are recommending controversial theories about the Quaran and Islamic history, and are striving to reinterpret Islam for the modern world. This is, as one scholar puts it, a "susceptible commerce." All the way through the past century, the Baha'is of Iran has been maltreated. With the victory of the Islamic upheaval in 1979, this persecution has been standardizing. More than 200 Baha'is have been executed or killed, hundreds more have been imprisoned, and tens of thousands have been deprived of jobs, pensions, businesses, and educational opportunities. All national Baha'i administrative structures have been banned by the government, and holy places, shrines and cemeteries have been confiscated, vandalized, or destroyed.

While we here at the Free thought Mecca often poke fun at our membership in various Zionist and Freemason funded conspiracies, the existence of real victims of such accusations is no laughing matter. The Baha'is in Iran has taken the role of the Jews in medieval Christian Europe. They are persecuted for crimes they committed only in the imagination of religious fascists. The powers that be in many Islamic countries have expressed a deep hatred for the gentle Baha'is, and openly acknowledge the faith as a threat to the true deem. The persecution is not only in Iran, but all over West Asia and North Africa. n January of 1986, one Egyptian cleric remarked that "a Baha'i deserves the penalty of an apostate... one who should either be brought to repentance or killed."² This is how the "tolerant" and "loving" scholars of Allah's true religion feel about those who put forth a more peace-loving version of their faith.

This deep animosity for the Baha'is is found on every level of the global ummah, from high-ranking clerics, to part-time cyber-mujahideen thugs who invade Baha'i newsgroups and chats. The fact that Muslims would show so much hatred for such a tolerant religion is one that leaves yet another black eye on the already besmirched record of the Islamic religion. Because of this, the Muslims often try justify their hatred for Baha'is by cooking up all sorts of insane conspiracy theories about them being Zionists, Free Masons, or a plot hatched by the Soviets. The first step was to follow in the footsteps of similar sorts of insane conspiracy theories launched at the Jews. Just as there is the Protocols of the Elders of Zion³, anti-Baha'i fascists cooked up the fictitious Memoirs of Count Dogorouki, a manuscript of Persian origin that claims a Russian diplomat confessed to creating the Baha'i faith as part of a plot to extend Russian imperialism. After the Russian revolution, interpretations of the Memoirs were changed to claim that the Baha'i faith was a Soviet/Marxist conspiracy. When Britain tried to colonize Iran, the claim that the Baha'is were "British agents" became quite popular⁴. Of course, after the creation of the state of Israel, the fact that the Baha'is had headquarters in Haifa helped corroborate the claim that they were "Zionists." Another tag that was later added was that of "Freemasons" (which is a wholly ambiguous term for the collective bogeyman from the Islamic standpoint, and has nothing to do with the realities of that Fraternal order).

The religion of Mohammad (SM) as envisaged in Al-Quaran ensures an ideal life based on codes, ethics, regulation and rules truly applicable to all humans. Al Quaran is the complete code of life with which there is a sequential flow in between death and life. This eternity is a very temporary life but the transient growth of human lives one day will finish and thereafter another life will start and as such we are afraid of almighty whether our punishment will be more after eternal life. It is said that Man is unjust, God is just and finally justice triumph. Our prophet’s life was not a bed of roses; rather it was based on bed of thorns. Through unlimited sorrows, he has spent his life and by utmost hard struggling, he has established and enriched his religion ‘Islam’. As has highlighted, it is evident that not only Bahai, but also many people of variety of communities through out the whole world misguide the lives of the muslins and as such, the muslins have struggled to establish the truth which is bestowed by God. All men are created equally but presently, the differentials and degradation against the Muslims have been created tremendously. We should forget any obstacles and rather we should embrace one another under the shadow of peace and prosperity of life. Prophet Mohammad(SM) has taught forgiveness, justice, equality, fraternity, peace and humanity of live. In this context, two lines of poem composed by Rudyard Kipling is worth mentioning:

‘Forgiveness free of evil done

And love to all men neath the sun’

Kidney Stones

There is no denying the fact that the urinary system comprises of the kidneys, ureters, bladder, and urethra. The kidneys are two bean-shaped organs positioned beneath the ribs toward the middle of the back. The kidneys remove extra water and wastes from the blood, converting it to urine. They also keep a stable balance of salts and other substances in the blood.

The kidneys bring into being hormones that help build brawny bones and help form red blood cells. Narrow tubes called ureter carry urine from the kidneys to the bladder, an oval-shaped chamber in the lower abdomen. Like a balloon, the bladder's stretchy walls and develop to store urine. They compress together when urine is emptied through the urethra to outside the body.

A kidney stone is a hard mass developed from crystals that separated from the urine and build up on the inner surfaces of the kidney. Normally, urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine without being noticed. Kidney stones may contain various combinations of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person's normal diet and make up important parts of the body, such as bones and muscles.

A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. A bit less common is the uric acid stone. Cystine stones are rare.

Urolithiasis is the medical term used to describe stones occurring in the urinary tract. Other frequently used terms are urinary tract stone disease and nephrolithiasis. Doctors also use terms that describe the location of the stone in the urinary tract. For example, a ureteral stone (or ureterolithiasis) is a kidney stone found in the ureter. To keep things simple, however, the term "kidney stones" is used throughout this fact sheet.

Gallstones and kidney stones are not related. They form in different areas of the body. If you have a gallstone, you are not necessarily more likely to develop kidney stones.

For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 30 years. The prevalence of stone-forming disease rose from 3.8 percent in the late 1970s to 5.2 percent in the late 1980s and early 1990s. White Americans are more prone to develop kidney stones than African Americans. Stones occur more frequently in men. The prevalence of kidney stones rises dramatically as men enter their 40s and continues to rise into their 70s. For women, the prevalence of kidney stones peaks in their 50s. Once a person gets more than one stone, others are likely to develop. Doctors do not always know what causes a stone to form. While certain foods may promote stone formation in people who are susceptible, scientists do not believe that eating any specific food causes stones to form in people who are not susceptible. A person with a family history of kidney stones may be more likely to develop stones. Urinary tract infections, kidney disorders such as cystic kidney diseases, and certain metabolic disorders such as hyperparathyroidism are also linked to stone formation. In addition, more than 70 percent of people with a rare hereditary disease called renal tubular acidosis develop kidney stones.

Cystinuria and hyperoxaluria are two other rare, inherited metabolic disorders that often cause kidney stones. In cystinuria, too much of the amino acid Cystine, which does not dissolve in urine, is voided. This can lead to the formation of stones made of Cystine. In patients with hyperoxaluria, the body produces too much of the salt oxalate. When there is more oxalate than can be dissolved in the urine, the crystals settle out and form stones.

Hypercalciuria is inherited. It is the cause of stones in more than half of patients. Calcium is absorbed from food in excess and is lost into the urine. This high level of calcium in the urine causes crystals of calcium oxalate or calcium phosphate to form in the kidneys or urinary tract.

Other causes of kidney stones are hyperuricosuria which is a disorder of uric acid metabolism, gout, excess intake of vitamin D, urinary tract infections, and blockage of the urinary tract. Certain diuretics which are commonly called water pills or calcium-based antacids may increase the risk of forming kidney stones by increasing the amount of calcium in the urine.

Calcium oxalate stones may also form in people who have a chronic inflammation of the bowel or who have had an intestinal bypass operation, or ostomy surgery. As mentioned above, struvite stones can form in people who have had a urinary tract infection. People who take the protease inhibitor indinavir, a drug used to treat HIV infection, are at risk of developing kidney stones.

Kidney stones often do not cause any symptoms. Usually, the first symptom of a kidney stone is extreme pain, which occurs when a stone acutely blocks the flow of urine. The pain often begins suddenly when a stone moves in the urinary tract, causing irritation or blockage. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin. If the stone is too large to pass easily, pain continues as the muscles in the wall of the tiny ureter try to squeeze the stone along into the bladder. As a stone grows or moves, blood may appear in the urine. As the stone moves down the ureter closer to the bladder, you may feel the need to urinate more often or feel a burning sensation during urination.

If fever and chills accompany any of these symptoms, an infection may be present. In this case, you should contact a doctor immediately.

Sometimes "silent" stones-those that do not cause symptoms-are found on x rays taken during a general health exam. If they are small, these stones would likely pass out of the body unnoticed.

More often, kidney stones are found on an x ray or sonogram taken on someone who complains of blood in the urine or sudden pain. These diagnostic images give the doctor valuable information about the stone's size and location. Blood and urine tests help detect any abnormal substance that might promote stone formation.

The doctor may decide to scan the urinary system using a special test called a CT (computed tomography) scan or an IVP (intravenous pyelogram). The results of all these tests help determine the proper treatment.

How are kidney stones treated?

Fortunately, surgery is not usually necessary. Most kidney stones can pass through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. Often, you can stay home during this process, drinking fluids and taking pain medication as needed. The doctor usually asks you to save the passed stone(s) for testing. (You can catch it in a cup or tea strainer used only for this purpose.)

The First Step: Prevention

If you've had more than one kidney stone, you are likely to form another; so prevention is very important. To prevent stones from forming, your doctor must determine their cause. He or she will order laboratory tests, including urine and blood tests. Your doctor will also ask about your medical history, occupation, and eating habits. If a stone has been removed, or if you've passed a stone and saved it, the laboratory should analyze it because its composition helps in planning treatment.

You may be asked to collect your urine for 24 hours after a stone has passed or been removed. The sample is used to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate, and cretonne (a product of muscle metabolism). Your doctor will use this information to determine the cause of the stone. A second 24-hour urine collection may be needed to determine whether the prescribed treatment is working.

Lifestyle Changes

A simple and most important lifestyle change to prevent stones is to drink more liquids-water is best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, including dairy products, may help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones.

You may be told to avoid food with added vitamin D and certain types of antacids that have a calcium base. If you have very acidic urine, you may need to eat less meat, fish, and poultry. These foods increase the amount of acid in the urine.

To prevent Cystine stones, you should drink enough water each day to dilute the concentration of cystine that escapes into the urine, which may be difficult. More than a gallon of water may be needed every 24 hours, and a third of that must be drunk during the night.

Foods and Drinks Containing Oxalate

People prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods if their urine contains an excess of oxalate:

·         beets

·         chocolate

·         coffee

·         cola

·         nuts

·         rhubarb

·         spinach

·         strawberries

·         tea

·         wheat bran

People should not give up or avoid eating these foods without talking to their doctor first. In most cases, these foods can be eaten in limited amounts.

Medical Therapy

The doctor may prescribe certain medications to prevent calcium and uric acid stones. These drugs control the amount of acid or alkali in the urine, key factors in crystal formation. The drug allopurinol may also be useful in some cases of hyperuricosuria.

Doctors usually try to control Hypercalciuria, and thus prevent calcium stones, by prescribing certain diuretics, such as hydrochlorothiazide. These drugs decrease the amount of calcium released by the kidneys into the urine by favoring calcium retention in bone. They work best when sodium intake is low.

Very rarely, patients with Hypercalciuria may be given the drug sodium cellulose phosphate, which binds calcium in the intestines and prevents it from leaking into the urine.

If Cystine stones cannot be controlled by drinking more fluids, your doctor may prescribe drugs such as Thiola and Cuprimine, which help reduce the amount of Cystine in the urine. For struvite stones that have been totally removed, the first line of prevention is to keep the urine free of bacteria that can cause infection. Your urine will be tested regularly to be sure that no bacteria are present.

If struvite stones cannot be removed, your doctor may prescribe a drug called acetohydroxamic acid (AHA). AHA is used with long-term antibiotic drugs to prevent the infection that leads to stone growth.

People with hyperparathyroidism sometimes develop calcium stones. Treatment in these cases is usually surgery to remove the parathyroid glands (located in the neck). In most cases, only one of the glands is enlarged. Removing the glands cures the patient's problem with hyperparathyroidism and with kidney stones as well.

Surgical Treatment

Surgery should be reserved as an option for cases where other approaches have failed. Surgery may be needed to remove a kidney stone if it:

·         does not pass after a reasonable period of time and causes constant pain

·         is too large to pass on its own or is caught in a difficult place

·         blocks the flow of urine

·         causes ongoing urinary tract infection

·         damages kidney tissue or causes constant bleeding

·         Has grown larger (as seen on follow-up x ray studies).

Until 20 years ago, surgery was necessary to remove a stone. It was very painful and required a recovery time of 4 to 6 weeks. Today, treatment for these stones is greatly improved, and many options do not require major surgery.

Extracorporeal Shockwave Lithotripsy

Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into sand-like particles and are easily passed through the urinary tract in the urine.

In most cases, ESWL may be done on an outpatient basis. Recovery time is short, and most people can resume normal activities in a few days.

Complications may occur with ESWL. Most patients have blood in their urine for a few days after treatment. Bruising and minor discomfort in the back or abdomen from the shock waves are also common. To reduce the risk of complications, doctors usually tell patients to avoid taking aspirin and other drugs that affect blood clotting for several weeks before treatment.

Another complication may occur if the shattered stone particles cause discomfort as they pass through the urinary tract. In some cases, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone is not completely shattered with one treatment, and additional treatments may be needed. ESWL is not ideal for very large stones.

Percutaneous Nephrolithotomy

Sometimes a procedure called percutaneous nephrolithotomy is recommended to remove a stone. This treatment is often used when the stone is quite large or in a location that does not allow effective use of ESWL.

One advantage of percutaneous nephrolithotomy over ESWL is that the surgeon removes the stone fragments instead of relying on their natural passage from the kidney.

Ureteroscopy Stone Removal

Although some kidney stones in the ureter can be treated with ESWL, ureteroscopy may be needed for mid- and lower-ureter stones. No incision is made in this procedure. Instead, the surgeon passes a small fibrotic instrument called an ureteroscopy through the urethra and bladder into the ureter. The surgeon then locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a form of shock wave. A small tube or stent may be left in the ureter for a few days to help the lining of the ureter heal. Before fiber optics made ureteroscopy possible, physicians used a similar "blind basket" extraction method. But this outdated technique should not be used because it may damage the ureter.

Hope through Research

CIDPUSA has done research to provide you with herbal and homeopathic treatment that will remove all stones at home. Try this at home today. People who had surgeons tell them that they were at surgical risk have been helped by cidpusa protocol of herbs at home.

Prevention Points to bear in mind

·         If  we  have a family history of stones or have had more than one stone, we are likely to develop more stones.

·         A good first step to thwart the formation of any type of stone is to drink plenty of liquids-water is best.

·         If you are at risk for developing stones, your doctor may perform certain blood and urine tests to determine which factors can best be altered to reduce that risk.

·         Some people will need medicines to prevent stones from forming.

·         People with chronic urinary tract infections and stones will often need the stone removed if the doctor determines that the infection results from the stone's presence.

In view of the above it is evident that a doctor has a burdened duty to serve the patients on humanitarian grounds. A doctor needs a patient and as such the patients need service of the doctor who is found considerate as well as dutiful personality. In the above problems and complicacy, the doctors must be responsibility in order to take care of the patients.