Famous Stone Patients and Their Disease

BJU International, 2002

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2018

Ahi Ahmed Çelebi was a famous Turkish physician in 16th Century. He was the head physician of Bayazıd II, Yavuz Sultan Selim, and the Magnificent Suleiman. He had worked extensively on urolithiasis and published his first work as a pamphlet in "Risala al-Kilya wa'l-Mathana". Interestingly, most of his observations regarding the etiology of calculus had great similarity to our present knowledge, especially about dietary habits. He said that "it is prevalent among the people of the upper class. The reason is the people of this class have much comfort and much eating and drinking, which are important factors in stone formation". He explained details of etiological factors, the organs that stones may appear, the symptoms of kidney/bladder stones, prophylactic and curative precautions against urolithiasis, and a few surgical methods. He had been describing some tools used for stucked stones. He mentions about Keyvan Bey who suffering from stucking bladder stone, and invented an apparatus, which is used on himself. Ahi Ahmed Çelebi described it with details; it was a pivot like silver bore containing holes on it, like on flutes. When the sensation to urinate occurs, he inserted this apparatus from its thinner end through the urethra, and push the calculus a little behind. Then, he withdraw the apparatus after successful voiding conducted through holes, like a urinary catheter used today. He also mentioned from an instrument, like a lithotriptor. Five centuries ago, while some observations and suggestions overlap with current knowledge, some treatment methods seem to be based entirely on experimental observations.

BJU International, 2003

a common denominator is the high risk of recurrent stone formation when the first stone is removed, although there is considerable variation among individuals [10].

JPMA. The Journal of the Pakistan Medical Association, 2009

To review 17 years experience of the stone clinic with incorporating the changes in practice over the years and to report the benefits of stone clinic in a developing country. The SIUT Stone clinic was established in 1990 with installation of HM4 Lithotriptor. This clinic is run jointly by a Urologist, Dietitian, Nephrologist, Biochemist and Radiologist. From 1990 - 2007, about 38,749 stone patients received treatment with ESWL (55%), PCNL (6.0%), URS (15.5%), litholopaxy 4.0% and open surgery 19.7%. These patients after treatment were followed in the stone clinic with stone analysis and 24 hours urine metabolic studies where indicated. Dietary and oral hydration programme combined with medical therapy was also instituted. Recurrence rate was noted in those patients who were advised diet modification, oral hydration and medical treatment. Complications of stone disease were documented during the follow-up period. In ESWL group 8226 patients were followed in the stone clinic for 5 ye...

BJU international, 2016

To analyse the trends in the number of deaths attributable to urolithiasis in England and Wales over the past 15 years (1999-2003). Urolithiasis has an estimated lifetime risk of 12% in males and 6% in females. It is not perceived as a life-threatening pathology. Admissions with urinary calculi contribute to 0.5% of all inpatient hospital stays. The number of deaths attributable to stone disease has yet to be identified and presented. Office of National Statistics Data relating to causes of death from urolithiasis, coded as ICD-10 N20-N23, was collated and analysed for the 15 year period from 1999-2013 in England and Wales. This data is sub-categorised into anatomical location of calculi, age and gender. A total of 1954 deaths were attributed to urolithiasis from 1999-2013 (mean 130.3 deaths/year). Of which, 141 were attributed to ureteric stones (mean 9.4 deaths/year). Calculi of the kidney and ureter accounted for 91% of all deaths secondary to urolithiasis; lower urinary tract (b...

Indian Journal of Unani Medicine

In Unani system of medicine renal stone named as Hasat e Kulliya (kidney stones), Hasat e halib (uretric stones), Hasat e masana (bladder stone). Kidney stones or Renal Calculi (from Latin renes, "kidney" and calculi, "pebbles") are solid structures composed of urinary precipitates and crystals. These stones can range in size from less than a millimeters to few centimeters. From ancient time Greeks have many literatures in which they explained urinary stone disease in detail. The association of stones and putrefaction has been known since Hippocrates (460–377 BC). He was first who described diseases of kidney and symptoms of bladder stones. Many Unani physicians explained surgical procedure and instruments used for removal of stone. The aim of this review to explain renal stone in vision of unani medicine.

Journal of Clinical Investigation, 2005

About 5% of American women and 12% of men will develop a kidney stone at some time in their life, and prevalence has been rising in both sexes. Approximately 80% of stones are composed of calcium oxalate (CaOx) and calcium phosphate (CaP); 10% of struvite (magnesium ammonium phosphate produced during infection with bacteria that possess the enzyme urease), 9% of uric acid (UA); and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stones. Stones ultimately arise because of an unwanted phase change of these substances from liquid to solid state. Here we focus on the mechanisms of pathogenesis involved in CaOx, CaP, UA, and cystine stone formation, including recent developments in our understanding of related changes in human kidney tissue and of underlying genetic causes, in addition to current therapeutics. Clinical aspects of stone disease Stone passage Nonobstructing stones produce no symptoms or signs apart from hematuria. Stone passage produces renal colic that usually begins as a mild discomfort and progresses to a plateau of extreme severity over 30-60 minutes. If the stone obstructs the uretero-pelvic junction, pain localizes to the flank; as the stone moves down the ureter, pain moves downward and anterior. Stones at the uretero-vesicular junction often cause dysuria and urinary frequency mistaken for infection. Colic is independent of body position or motion and is described as a boring or burning sensation associated with nausea and vomiting. Stones less than 5 mm in diameter have a high chance of passage; those of 5-7 mm have a modest chance (50%) of passage, and those greater than 7 mm almost always require urological intervention. Ideally, stone analysis is performed by infrared spectroscopy or x-ray diffraction. Renal stone burden is best gauged using CT radiographs taken with 5-mm cuts, without infusion of contrast agents. The radiographic appearance and density of stones as measured by CT is a guide to their composition (1). Urological management of stones Extracorporeal shock wave lithotripsy (ESWL), in which sound waves are used to break the stone into small pieces that can more easily pass into the bladder, is widely used and valuable for small stones (2). Modern instruments facilitate passage of endoscopes up the ureter into the kidney pelvis and permit local stone disruption with high-powered lasers (3). Percutaneous stone removal via instruments introduced into the kidney through a small flank incision permits disruption and removal of even very large stones (4). Renal function of stone forming people is reduced Within the National Health and Nutrition Examination Survey III data set, subjects with a BMI greater than or equal to 27 who had kidney stones had lower estimated glomerular filtration rates than non-stone formers (non-SFs) matched for age, sex, race, and BMI (5). SFs also have higher blood pressures than non-SFs (6). Obstruction of the urinary tract, sequelae of urological interventions, and the processes that cause stone formation may all injure renal tissue, reduce renal function, and raise blood pressure. Determinants of phase change Supersaturation Stones result from a phase change in which dissolved salts condense into solids, and all phase changes are driven by supersaturation (SS), which is usually approximated for such salts by the ratio of their concentration in the urine to their solubilities (7) and calculated by computer algorithms. At SS values less than 1, crystals of a substance will dissolve; at SS values greater than 1, crystals can form and grow. As expected, the composition of stones that patients form correlates with SS values from the urine they produce (8). Although increasing urine volume is an obvious way to lower SS, patients examined in a variety of practice settings have been found to be able to increase their urine volume by an average of only 0.3 l/d (9). Moreover, for unclear reasons, sodium intake and urinary calcium excretion has been found to increase with increased urine volume, partly offsetting the fall in SS. Along with urine volume, urine calcium and oxalate concentrations are the main determinants of calcium oxalate (CaOx) SS; urine calcium concentration and pH are the main determinants of calcium phosphate (CaP) SS; and urinary pH is the main determinant of uric acid (UA) SS. The upper limit of metastability Urine with SS greater than 1 is referred to as metastable because the excess dissolved material, being present at a concentration above its solubility, must eventually precipitate. One can add oxalate or calcium to urine and note the SS needed to produce a solid phase of CaOx or CaP. That value, called the upper limit of metastability (ULM), varies with urine SS (10) and is lower among patients with stones than in matched control subjects (11). This suggests that mechanisms that normally protect against solidphase development are less effective in patients with stones than healthy individuals. Urine contains molecules that retard the for

Approaches to Teaching The Story of the Stone, 2012

2019

Stone may form at any level in the urinary tract, but mostly in the kidney. Urolithiasis (Stone formation in the urinary tract) is a very common problem with the reported increasing prevalence across the world. Males are affected somewhat more than females. It is imperative to increase understanding of the concept of its formations, particularly about the various causative factors, which play a role to lead its initiation. Here in, we reviewed the literature of medical science, particularly Arabic, Persian and Urdu manuscripts/literature of Unani medical system, having information regarding the formation and causative factors of this disorder. Google scholar, PubMed, Science direct and Ovid were searched to review the literature of modern research publications containing information on the subject. At the conclusion, it was noticed that the incidence and prevalence of Urolithiasis is increasing across the sex, race and age of the patients all over the world and role of diet is seeme...