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.

The concept of privatization

    The concept of privatization   

Suffice it to say that the modern approach of privatization relates to the remarkable statement was that in 1988, Cook and Kirkpatrick have identified three main approaches to privatisation: • Change in the ownership of an enterprise from the public to private sector. Denationalization or divestiture can be the means to accomplish this. • Privatization through liberalization, or deregulation, of entry into activities previously restricted to public sector enterprises. 

It is argued that the removal of restrictions is intended to increase the role of competition in the hitherto protected market, a variant of privatisation will have occurred, even though  the transfer of ownership of assets has been involved. • Where the provision of a good and service is transferred from the public to private sector, while the government retains ultimate responsibility for supplying the service. Franchising or contracting-out, of public services and the leasing of public assets to the private sectors are examples. Privatization as policy has been allied with various objectives. Introduction or extension of market forces reflected in the profit motive, competition, greater efficiency and innovation are expected to benefit the consumers. 

Privatization policy has also been linked with a longing for wider share ownership and a creation of share-owning democratic system; while in some cases, the policy aims to trim down the size of the public sector through the policy of nationalization. “Perspective Proposals have also been made that in some countries like UK, Malaysia, China and South Africa); the real purpose of the policy is to reduce the monopoly power of the public sector trade unions”. But some of the above objectives may be in conflict. 

Reducing the size of the public sector by selling public assets may not be compatible with the goal of efficiency if it involves merely transferring monopoly power from the public to the private sector without ensuring competition and rivalry. Maximizing the number of shareholders may be achieved by under pricing of share, which is in conflict with the aim to maximize the treasury income following the rules and perspectives of private sector phenomena.

Indoor Pollution

According to Commoneous, a renowned educationists," What comes from God is true and with the touch of human beings, it becomes untrue". Again, in this context, Keats says," The truth is beauty and beauty is truth ". Hence all the sources of beauties and the truth are this world. The world we live in is the most attractive place with striking landscapes and features, wild and domesticated animals, and a variety of odoriferous flowers, evergreen trees and the most wonderful creation of the Lord- the human beings.

The world has been created for the human beings so that they would applause the Lord for his power and preserves these natural beauties with undiminished care. But ever since, the world began; man has been doing the opposite thing bit by bit. He has been making progress in science and industry; great deals of landscape and wild life are being abolished day by day. Over population in small areas has given birth to traffic jam and poverty, which destroys the people. Trees have been cut down to make way for construction of modern buildings. Waste disposal is discarded on land and water, which spread mosquitoes. Mosquitoes enter the household and sit on food and spray dirt on the food from the waste and many more harmful activities for which man has started to destroy the beauty of the world. In clearing forests to create fields for farming and constructing new houses, man destroys the native animals and takes away their sources of food. His domestic animals kill them or man haunts them for meat, ivory or furs. Consequentially, the numbers of those haunted animals are minimized and a few numbers of these animals'' lives are at stake. The contamination are common phenomena through out the world causing a great crisis against our healthy environment in question. Our environment is greatly being polluted every time due to air and water pollution. Air is mainly being polluted from smokes. When the bricks are burnt, unbounded smokes are created. The compositions of such smoke particles are nicotine, thiophin, Furan, phosgene, sulfur dioxide and pyridine. These particles pollute the air tremendously.

The smokes are also created when different vehicles ply over along the streets. For these reasons, all the streets are filled with the smokes that adversely affect the human health conditions. Burning poisonous gases like sulfur dioxide, nitrous oxides, nitric acids and sulfuric acids, again create the smokes. These particles make the air heavy and polluted. In view of the above, it is evident that in order to construct buildings, dams and embankments, lots of plants and trees are cut down and subsequently these are burnt for bricks for which air is polluted to a great extent. In the winter-based country, the plants and trees are being planted in the artificial manner by storing sun light under some restricted environment.

 In view of the above discussion, it is obvious that the things which are being done in the green house, are the increasing of carbon dioxide, which affects the environment adversely. We need to ensure the proper use of carbon dioxide by growing the plants and trees adequately without which congenital atmosphere for our survival on earth would not have been possible. Finally, we should find out ways and means to save our environment from being polluted of our environment. We should also look after our indoor environment where in all of our daily intervention of work, our indoor environment is always being polluted. We should be careful in handling our daily need so that our daily debris emanating from our continuous house-hold affairs so that we can save ourselves from health hazards as a tentative flow Source: http://www.shvoong.com/social-sciences/1728320-indoor-pollution/#ixzz3FlbTM5dS

Modern world draw back

There is no denying the fact that today’s world is not peaceful, moderate and refined, rather it is full of perils and threatening. Still today, unlimited social evils are prevailing in the world. Not only in our country, but also in many parts of the world, corruption, terrorism, dowry system, traffic congestion, pollution and high rate of population exist tremendously. Formerly, the people were peaceful in the sense that they did not know how to use weapons to spoil others. In modern world, the use of atomic energy has been mischievously enhancing for which the safely survival for humans are being painstaking day by day. If we look around the world, we will observe that the numbers of wars are increasing day by day for which the war against terrorism is a burning question of the day. The history says, by a mammoth invasion of the terrorists, the world largest business centre situated in America has been crushed. It is a matter of great regret that the super power countries like USA, Germany, France, Russia and Great Britain failed to retaliate such attacks. It is important to note that in Hiroshima and Nagashika of Japan during First World War, atom bomb had been thrown on the soil of Japan, the first sun rising country. The effect of such atom bomb was so fatal that even today; such poisonous influences are widespread in the world on a large scale. Modern world is the world of threat, perils and painful and as such, the war of Vietnam was dangerous that unlimited people had been killed. The war of Iraq is most destructive and heinous because each and every day due to terrorism attack, uncounted people are being killed irrespective of high or low. The peace loving forces are trying to control the country relating to law and order situation, but it is becoming difficult to control the country on the part of the alliance forces against the rebel forces. The rebel forces think that hey are fighting against the occupancy of foreign foes and according to them, they will fight till date until or unless Iraq is liberated. From the consequences of such war, we can decide that all wars cannot bring good harvest rather than the people of the world who do not find any ways to live with peace, society, friendship and love. In the midst of many arguments and debates, it seems that today’s world is full of perils and dangerous place. Due to the fact that corruption exists tremendously for which we can say that where there is no accountability, there lies corruption and it occurs in case of dealing money in exchange of anything. In my opinion, it is the sum of total resources expressed in terms of current monetary units and the discretion power which is the authority and empowerment to spend and minus accountability. Moreover, Smoking emerge due to delay in healing of stomach ulcers; it trims down the senses of smell and taste; slows down reflexes which causes smokers more prone to accidents; and gives an unpleasant smell from the breath, clothes, and homes of smokers. Very current survey illustrates that smokers endanger the health of non-smokers. Pregnant women smokers tend to have smaller babies than non-smokers, and their babies are more likely to be born dead or die a few days after birth. Besides such tremendously adverse affects, the children of smoking parents have more lung infections in the first years of life than the children of non-smokers. During one hour in a smoky room, a non-smoker can inhale as much cancer-causing substances as some one smoking 15 filter-tip cigarettes. Illness related to smoking is very expensive. In U.K., France, Germany, China and USA, it results in the loss of about 60 millions working days a year, treatment costs several hundreds thousands dollar a day, and it causes the death of over a million people a week. However, those who give up smoking greatly reduce their chances of developing diseases