Occurrence Of Stones Research Articles

Factors That Can Affect the Occurrence Urinary Stone

Urinary tract stones are the biggest health problem in the field of urology with typical symptoms of pain that can lead to complications in the kidneys. The formation of the stones in the urinary tract (kidneys, ureters, and uretra) due to the deposition of substances in abnormal amounts caused by internal and external factors. The purpose of this study was to determine the factors that can influence the occurrence of Urinary Tract Stones. This study uses a literature review. The Literature Review search uses a database with Google Scholar and keywords that are adjusted to the Medical Subject Heading (MeSH). Data analysis used quality analysis methodology with checklists. The results showed the factors that influence the occurrence of urinary tract stones, among others; heredity, age, gender (male), obesity (BMI> 25) and behavior (regulation of fluid intake <1500 ml per day, diet (consumption of high oxalate vegetables), and length of time to sit. Education to the public through health services regarding the factors that can affect the incidence of urinary tract stones needs to be implemented.
 Keywords: Factors, Urinary Tract Stones
 Urinary tract stones are the biggest health problem in the field of urology with typical symptoms of pain that can lead to complications in the kidneys. The formation of the stones in the urinary tract (kidneys, ureters, and uretra) due to the deposition of substances in abnormal amounts caused by internal and external factors. The purpose of this study was to determine the factors that can influence the occurrence of Urinary Tract Stones. This study uses a literature review. The Literature Review search uses a database with Google Scholar and keywords that are adjusted to the Medical Subject Heading (MeSH). Data analysis used quality analysis methodology with checklists. The results showed the factors that influence the occurrence of urinary tract stones, among others; heredity, age, gender (male), obesity (BMI> 25) and behavior (regulation of fluid intake <1500 ml per day, diet (consumption of high oxalate vegetables), and length of time to sit. Education to the public through health services regarding the factors that can affect the incidence of urinary tract stones needs to be implemented.
 Keywords: Factors, Urinary Tract Stones

Disrupting Crystal Growth through Molecular Recognition: Designer Therapies for Kidney Stone Prevention.

Aberrant crystallization within the human body can lead to several disease states or adverse outcomes, yet much remains to be understood about the critical stages leading to these events, which can include crystal nucleation and growth, crystal aggregation, and the adhesion of crystals to cells. Kidney stones, which are aggregates of single crystals with physiological origins, are particularly illustrative of pathological crystallization, with 10% of the U.S. population experiencing at least one stone occurrence in their lifetimes. The human record of kidney stones is more than 2000 years old, as noted by Hippocrates in his renowned oath and much later by Robert Hooke in his treatise Micrographia. William Hyde Wollaston, who was a physician, chemist, physicist, and crystallographer, was fascinated with stones, leading him to discover an unusual stone that he described in 1810 as cystic oxide, later corrected to cystine. Despite this long history, however, a fundamental understanding of the stages of stone formation and the rational design of therapies for stone prevention have remained elusive.This Account reviews discoveries and advances from our laboratories that have unraveled the complex crystal growth mechanisms of l-cystine, which forms l-cystine kidney stones in at least 20 000 individuals in the U.S. alone. Although l-cystine stones affect fewer individuals than common calcium oxalate stones, they are usually larger, recur more frequently, and are more likely to cause chronic kidney disease. Real-time in situ atomic force microscopy (AFM) reveals that the crystal growth of hexagonal l-cystine is characterized by a complex mechanism in which six interlaced anisotropic spirals grow synchronously, emanating from a single screw dislocation to generate a micromorphology with the appearance of stacked hexagonal islands. In contrast, proximal heterochiral dislocations produce features that appear to be spirals but actually are closed loops, akin to a Frank-Read source. These unusual and aesthetic growth patterns can be explained by the coincidence of the dislocation Burgers vector and the crystallographic 61 screw axis. Inhibiting l-cystine crystal growth is key to preventing stone formation. Decades of studies of "tailor-made additives", which are imposter molecules that closely resemble the solute and bind to crystal faces through molecular recognition, have demonstrated their effects on crystal properties such as morphology and polymorphism. The ability to visualize crystal growth in real time by AFM enables quantitative measurements of step velocities and, by extension, the effect of prospective inhibitors on growth rates, which can then be used to deduce inhibition mechanisms. Investigations with a wide range of prospective inhibitors revealed the importance of precise molecular recognition for binding l-cystine imposters to crystal sites, which results in step pinning and the inhibition of step advancement as well as the growth of bulk crystals. Moreover, select inhibitors of crystal growth, measured in vitro, reduce or eliminate stone formation in knockout mouse models of cystinuria, promising a new pathway to l-cystine stone prevention. These observations have wide-ranging implications for the design of therapies based on tailor-made additives for diseases associated with aberrant crystallization, from disease-related stones to "xenostones" that form in vivo because of the crystallization of low-solubility therapeutic agents such as antiretroviral agents.

Kidney stone depiction on fictional television: how accurate are they?

Fictional portrayals of medical conditions on television have been shown to significantly shape understanding and management expectations of the viewing public. Given the high prevalence of kidney stone disease, we aimed to assess the frequency of its portrayal on US television and assess whether its depiction was reflective of the current epidemiology or management of urolithiasis in the US. A detailed search was conducted for English language depictions of kidney stones in fictional television using internet, movie and television database search engines. Television episodes with characters depicting a kidney stone occurrence were independently reviewed by two reviewers and analyzed for genre, initial air date on US television, character age, gender, race and management strategy. Seventeen episodes from 13 different television series portrayed a character with a symptomatic kidney stone. The majority were male (88%). Surgical intervention was performed in 7/17 cases (shockwave lithotripsy n = 1, ureteroscopy n = 2, nephrectomy n = 1, transurethral removal n = 1, unknown n = 2), spontaneous passage or medical expulsive therapy in 7/17 cases and no treatment or resolution portrayed in 3/17 cases. The only surgical complication shown was ureteral avulsion during ureteroscopy. Inpatient management was seen in 9/14 (64%) cases with event resolution. This study identified a number of kidney stone depictions that may be misleading or misrepresent the presentation and management of this condition. Although likely portrayed for plot development and dramatic effect, this could potentially reinforce inaccurate beliefs or misconceptions and future depictions should be mindful of this.

The Diagnostic Value of GGT-Based Biochemical Indicators for Choledocholithiasis with Negative Imaging Results of Magnetic Resonance Cholangiopancreatography.

To reveal the relationship between a group of preoperative biochemical indicators such as GGT, ALP, ALT, AST, TB, and DB and the occurrence of common bile duct stones in patients with negative results of magnetic resonance cholangiopancreatography, a retrospective diagnostic accuracy clinical test is conducted in this study. In order to reduce the missed diagnosis rate of choledocholithiasis and perform more accurate common bile duct exploration, 466 patients who underwent surgical treatment of cholelithiasis from January 2014 to December 2015 have been analyzed retrospectively. Firstly, the confounding factors are corrected through Binary Logistic regression. Then, the diagnostic efficacy of each indicator is measured by the ROC curve among different types of patients. In all patients, the top three individual indicators with the greatest AUC curve area for predicting common bile duct stones can be observed from the results of MRCP, γ-glutamyl transpeptidase, and alkaline phosphatase. Besides, the diagnostic efficiency of the comprehensive evaluation is higher than that of all individual indicators. For MRCP-negative patients, the top three largest AUC curve area of the diagnostic efficacy for choledocholithiasis were GGT, ALP, and DB. For patients who have a suspected diagnosis of secondary choledocholithiasis, the diagnostic efficacy of the combination of imaging results, biochemical indexes, common bile duct width, and other abnormal indicators for choledocholithiasis is much higher than that of the single abnormal biochemical indexes for the prediction of choledocholithiasis. For MRCP-negative patients, GGT, ALP, DB, and the width of common bile duct diameter are valuable for the prediction of common bile duct stones, and GGT is the most valuable diagnostic predictor.

A Review on Antiurolithiatic (Pashanabeda) Effects of Herbal and Marine Resources

Urolithiasis (urinary calculi) is stone development in bladder, urinary tract and kidney. The rise in frequency and occurrence of kidney stones is talking point all over the world. 12% of the global population suffer from urinary stone formation. The phenomenon effect of urolithiasis is lowered by using the pashanabeda elements. Pashanabeda (Pashan: stone; bheda: to break) is a Sanskrit locution which implies the breakage of stone. The adverse reactions caused due to man made drugs has prompted to rejoin with the natural safe medication. The evolution of plant-based therapeutics has shown terrific notice and demand as an modernistic drug entities all over the sphere. The present review aims the investigators to easily identify and develop plant and marine resources beneficial in management of urolithiasis.

Composition and inhibitory properties of endogenous urinary GAGS are different in subjects from two race groups with different occurrence rates of kidney stones: Pilot studies provide unique evidence in support of an inhibitory role for this group of compounds

BackgroundCalcium oxalate (CaOx) kidney stone disease is common in South African whites (W) but is rare in the black population (B). The possible role of endogenous urinary glycosaminoglycans (GAGs) has not been previously investigated in this context. AimTo determine concentration, composition, structure and CaOx crystal-inhibiting properties of this group of compounds in ultrafiltered urine of healthy subjects from both groups. Materials and methodsGAGS were isolated from 24 h urine samples and were quantified and characterized by sequential precipitation, Bradford protein assay, high performance liquid chromatography, and anion exchange high performance chromatography. CaOx crystal inhibition was determined in ultrafiltered urinary fractions to which purified GAGS (PG) from each group (PGB and PGW) had been added. Nucleation, growth and aggregation were measured by Coulter particle counting, spectrophotometric assay and [14C]-oxalate deposition. ResultsHigher concentrations of chondroitin sulfate (CS) were found in PGB than in PGW. PGB inhibited crystallization to a greater extent than PGW. ConclusionsWe attribute the stronger inhibitory effect of PGB to its higher content of CS and suggest that the superior inhibition of CaOx crystallization by PGB relative to PGW might be a contributory factor in accounting for the lower stone occurrence rate in B.

A Cross Sectional Study on the Rising Frequency of Gallbladder Stones

Objective: The aim of this study was to determine the occurrence of cholelithiasis in the city of Lahore and its surrounding area. Material and Methods: This study was conducted at Shalamar Medical and dental college Lahore and data for this study was collected from different hospitals of Lahore and the duration of this study was from 2019 to 2021. The participants of this study were from both genders’ male and female from of the age of 10 years to 80 years, and the sample size for this study was 483 and 1583. The main focus of our study was to examine the occurrence of Cholelithiasis surgical in the duration of our study. A questionnaire was used to analyses the occurrence of gall stone, and also the sex, age and dietary habits of the patients. Results: In the results of this study the frequency of gall stones were observed 4.0% in males and 12.0% in females and the percentage of occurrence of gall stones in both these genders were 1% to 3.3%. the high occurrence rate of gall stones in the months are May and November, in both these months the observation of gall stones in these were very high. Both the genders were divided into two main age groups in which male age group were from 10 years to 78 years and the females age group were from 11 years to 80 years. The ideal age for the occurrence of gall stones in male were 45 years to 59 years and in females were 3 years to 44 years respectively. Conclusions: In the conclusion of this study, we examine that the overall occurrence of gall stones in both the genders were 7.01%, but at same the time occurrence rate in the females were very high as compared to the male which were 1% in males and 3.3% in females. Keywords: Cholelithiasis, Surgical Incidence, Gallstones.

Higher Triglyceride-Glucose Index Is Associated With Increased Likelihood of Kidney Stones.

AimsWe aimed to assess the association between triglyceride–glucose (TyG) index and kidney stones in US adults.MethodsData were obtained from the 2007–2014 National Health and Nutrition Examination Survey (NHANES). Participants aged ≥18 years who were not pregnant and provided complete data about TyG index and kidney stones were included in the analysis. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between TyG index and nephrolithiasis and recurrence.ResultsA total of 20,972 participants were included with the mean TyG index of 8.71 ± 0.72. The prevalence rates of nephrolithiasis and recurrence were 9.30% and 3.17% overall and increased with the higher TyG index tertiles (Nephrolithiasis: Tertile 1, 6.98%; Tertile 2, 9.15%; Tertile 3, 11.98%, p < 0.01; Recurrence: Tertile 1, 1.84%; Tertile 2, 3.27%; Tertile 3, 4.50%, p < 0.01). Each unit increase in TyG index was associated with 12% and 26% higher odds of nephrolithiasis [odds ratio (OR) = 1.12; 95% CI: 1.02–1.22; p = 0.02] and recurrence (OR = 1.26; 95% CI: 1.08–1.46; p < 0.01). Interaction tests indicated no significant effect of gender, age, body mass index, hypertension, and diabetes on this association between TyG index and kidney stones.ConclusionsHigher TyG index was associated with an increased likelihood of nephrolithiasis and recurrence. Considering TyG index is a reliable indicator of insulin resistance (IR). Treatment and management of IR at a younger age may improve or alleviate the occurrence and recurrence of kidney stones.

RECUR - Establishment of An Automated Digital Registry for Patients with Recurrent Stones in the Upper Urinary Tract

Kidney stones, like cardiovascular diseases and diabetes mellitus, affect a large number of people. Patients suffer from acute pain, repeated hospitalizations and associated secondary diseases, such as arterial hypertension and renal insufficiency. This results in considerable costs for the society and its health care system. The recurrence rate is as high as 50%. The registry for RECurrent URolithiasis (RECUR) aims to fill existing evidence gaps. The prospective and longitudinal RECUR registry is funded by the German Ministry of Education and Science (BMBF). It is based on the digital infrastructure of the German Medical Informatics Initiative (MII). RECUR aims to include patients that have suffered from more than one stone occurrence and treated at any one of the ten participating university hospitals of the MIRACUM consortium. The intention is to obtain new information on risk factors and to evaluate different diagnosis and treatment algorithms. Along with the data form the patient's Electronic Health Records (EHR), the RECUR project will also collect Patient Reported Outcomes data from patients with recurrent kidney stones. These data will be collected at participating sites using digital questionnaires via a smartphone app. These data will be merged with medical data from the hospital information systems and saved in the MII research data repositories. The RECUR registry has a model character due to its fully federated, digital approach. This allows the recruitment of many patients, the collection of a wide range of data and their processing with low administrative and personnel costs.

Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

A recent increase in the incidence of recurrent renal calcium oxalate calculi has been demonstrated. Although a few advances have shown that the increase in incidence of these stones is due to genetic causes, it is mostly associated with a change in environmental factors. Global warming and weather changes, some medications administered to young children and eating habits play a pivotal role in increasing stone incidence. By far the most important single factor in stone incidence involves the increased ingestion of red meat and salt. So much so that it is anticipated that calcium oxalate stone occurrence will increase pari passu with dietary changes in the South African black community. The reasons for the difference in the incidence between males and females (12% v. 6%) remain controversial, and should be further studied.

Biological and Geochemical Studies of Urinary Tract Stones in Lorestan Province

Mineralogy studies can help understand the interactions of geographical, environmental, and geological factors. Considering frequent occurrence of urinary tract stones in the south and west of Iran, the present paper examines trace elements, like heavy metals, in 53 urine stone samples collected from patients in Lorestan Province. It investigates the mineralogy of the stones, using X-ray diffraction. The samples are then classified into five mineral groups (calcium oxalate, urate, cysteine, calcium oxalate-urate, and calcium oxalate/phosphate). Results from this analysis are confirmed by SEM images, showing the crystalline form of the mineral phases. The microscopic studies show that only the mineral group of calcium oxalate (whewellite) could be detected in thin sections, prepared from urinary tract stone samples. The main and trace elements in each group are determined through ICP-MS method with the results showing that calcium is the most abundant substance in urinary tract stones, compared to other elements. This is caused by the role of calcium in most basic functions of cell metabolism. The correlation between magnesium and strontium is 0.64, originated from the placement of high amounts of strontium in calcium oxalate minerals. The positive correlation between sodium and calcium also indicates that sodium is replaced by calcium due to the similarity of the ionic radius in the crystal structure. Results from this study can help us find the causes behind the frequent occurrence of urinary tract stones in Lorestan Province.

Triglyceride-Glucose Index as a Novel Biomarker in the Occurrence of Kidney Stones: A Cross-Sectional Population-Based Study.

BackgroundTriglyceride–glucose (TyG) index has been considered as the reliable marker of insulin resistance (IR), which is one risk factor of kidney stone. This study aimed to evaluate the TyG index in the occurrence of kidney stones among the United States (US) population.MethodsParticipants who received assessment were retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The logistic regression analysis was conducted to assess the relationship between the TyG index and kidney stones occurrence. A 1:1 matched-pair analysis was established to optimize the bias in kidney stones by propensity score matching (PSM). The dose–response curve was performed to verify the association between the TyG index and risk of kidney stones.ResultsOf the 14,158 eligible enrolled participants, 1346 (9.5%) self-reported a history of kidney stones. All participants were divided into two groups (high TyG index group and low TyG index group) based on the median TyG index. The dose–response curve exhibited a positive non-linear correlation between the TyG index and kidney stones risk. High TyG index was related to increased kidney stones occurrence in participants, with adjusted odds ratios (AOR) of 1.14 (95% confidence intervals (CI): 1.01–1.30, P = 0.038) compared with the low TyG index subgroup before PSM. After PSM, the risk of kidney stones was 19% higher in the high TyG group compared with the low TyG group (AOR = 1.19, 95% CI: 1.02–1.38, P = 0.026), and the dose–response curve still showed a positive association between TyG index and kidney stone risk.ConclusionThe TyG index was independently associated with kidney stones and would be a novel biomarker in predicting occurrence for clinical decision.

Incidence and correlation of metabolic syndrome and kidney stones in a healthy screening population.

BackgroundTo study the incidence of metabolic syndrome (MetS) and kidney stones in a healthy screening population and to explore the correlation between them.MethodsThe physical examination data of 11,827 people screened at the First Affiliated Hospital of Soochow University from August 2019 to July 2020 were analyzed. MetS diagnostic criteria were based on the 2004 guidelines of Chinese Diabetes Society (CDS). Multivariate logistic regression was used to analyze the correlation between MetS and various characteristics and kidney stones. Trend analysis was represented by P value, and P<0.05 indicated statistical significance.ResultsThe present study comprised 6,570 males (55.6%, aged 46.15±13.653 years) and 5,257 females (44.4%, aged 41.41±11.712 years). Of these, 1,036 (8.8%) had kidney stones and 1,552 (13.1%) had MetS. Among the MetS patients, 35.1% had a body mass index (BMI) ≥25, 27.7% had hypertension, 10.8% had hyperglycemia, and 31.2% had dyslipidemia. Kidney stone morbidity was 14.5% in the MetS group and 7.9% in the non-MetS group (P<0.05). As the number of MetS characteristics increased, kidney stone morbidity showed a linear increasing trend (P<0.05 for trend). With an increase in BMI and blood triglycerides (TG), and a decrease in lipoprotein cholesterol (HDL-C), the incidence of kidney stones had an increasing trend (P<0.05 for trend). Sex, age and MetS were independent risk factors for the occurrence of kidney stones, with and odds ratio (OR) of 1.493 [95% confidence interval (CI): 1.264–1.763] for MetS. Of the MetS characteristics, BMI ≥25 and blood pressure (BP) ≥140/90 mmHg were independent risk factors for kidney stones, with OR values of 1.209 (95% CI: 1.047–1.396) and 1.248 (95% CI: 1.071–1.453), respectively.ConclusionsMetS is an independent risk factor for kidney stones. Appropriate medication and dietary advice may help to correct urinary metabolic abnormalities and prevent the recurrence of kidney stones.

Prediction of the occurrence of calcium oxalate kidney stones based on clinical and gut microbiota characteristics

PurposeTo predict the occurrence of calcium oxalate kidney stones based on clinical and gut microbiota characteristics.MethodsGut microbiota and clinical data from 180 subjects (120 for training set and 60 for validation) attending the West China Hospital (WCH) were collected between June 2018 and January 2021. Based on the gut microbiota and clinical data from 120 subjects (66 non-kidney stone individuals and 54 kidney stone patients), we evaluated eight machine learning methods to predict the occurrence of calcium oxalate kidney stones.ResultsWith fivefold cross-validation, the random forest method produced the best area under the curve (AUC) of 0.94. We further applied random forest to an independent validation dataset with 60 samples (34 non-kidney stone individuals and 26 kidney stone patients), which yielded an AUC of 0.88.ConclusionOur results demonstrated that clinical data combined with gut microbiota characteristics may help predict the occurrence of kidney stones.

Demographic, Chemical, and Helicobacter pylori Positivity Assessment in Different Types of Gallstones and the Bile in a Random Sample of Cholecystectomied Iranian Patients with Cholelithiasis.

Background The occurrence of stones in the gallbladder or common bile duct and the symptoms and complications they cause is called gallstone disease. The symptoms of gallstone disease range from mild, nonspecific symptoms to a severe right quadrant abdominal pain. Characteristics of gallstone types in an Iranian population have not been well studied before and there are very limited studies on the demographic pattern of stone types in our country, so this study is one of the first studies on its kind on the epidemiology of gallstone types in Iran. As information on chemical components of the stone will help in the management and prevention of gallstones, in this study, we aimed to do chemical component analysis of gallstones including cholesterol, bilirubin, and calcium. Given the conflicting reports about the relationship between H. pylori infections and gallstone formation, this study aimed to investigate the relationship between H. pylori positivity in the bile specimen of Iranian patients with cholelithiasis and formation and type of stone. Methods This prospective study reviewed a total of 196 patients who underwent cholecystectomy for symptomatic cholelithiasis at Shahid Beheshti Training and Research Hospital affiliated to the Yasuj University of Medical Sciences between September 2015 and May 2018. Chemical analysis of gallstone components performed using the colorimetry method. Microbiological analysis for H. pylori was done using the OnSite H. pylori Ag Rapid Test on the bile sample. For the validation test of bile, the H. pylori Rapid Stool Ag Test on stool was used, and Cohen's Kappa statistical analysis was done next. Results There were significant associations between the stone types and age, chemical composition of the stones such as calcium, cholesterol, and bilirubin levels, and also H. pylori positivity and cholesterol and bilirubin levels; however, no significant association was found between the stone types and sex, H. pylori positivity and age, sex, stone types, and calcium level. The main bile and validity tests were matched to the substantial agreement according to Cohen's Kappa analysis. The most common drugs used were proton pump inhibitors, nonsteroidal anti-inflammatory drugs, antihypertensive drugs, and oral contraceptives. Conclusions This study suggested that the chemical composition of the stones could predict the presence of bacteria, there is no correlation between H. pylori and gallstone formation, and some of the drugs could be predisposing factors for gallstones. This work provides an objective basis for further research into gallbladder stone formation; meanwhile, it has great significance in the treatment and prevention of gallbladder stones. Trial registration. The project was found to be in accordance to the ethical principles and the national norms and standards for conducting research in Iran with the approval ID IR.YUMS.REC.1399.147 and date 2020.09.23, and this project is the result of a residency dissertation to obtain the specialty in general surgery, which has been registered with the research project number 960159 in the Vice Chancellor for Research and Technology Development of the Yasuj University of Medical Sciences, Yasuj, Iran, URL: https://ethics.research.ac.ir/EthicsProposalViewEn.php?id=160634.

Association of Pulp Stones among Patients with Addictive Habits – A Descriptive Cross-Sectional Study

Aim: The study aimed to determine the association of pulp stones among patients with addictive habits in comparison with healthy individuals without any addictive habits. Materials and Methods: A total of 240 patients were included in the study, i.e., 120 patients with addictive habits and 120 healthy individuals without addictive habits. Bite-wing projection of the intact or sound teeth of one side, i.e., either right or left side of the first and second molars of the upper and lower arch was obtained. The presence or absence of pulp stones was observed for the selected teeth. The Chi-square analysis was used to evaluate and compare the occurrence of pulp stones among patients with addictive habits and healthy individuals of a similar age group. Results: Of the 960 teeth examined from both groups, 111 (11.56%) teeth had pulp stones. Pulp stones were observed among 43 patients with addictive habits and in 30 healthy individuals. The occurrence of pulp stones was higher in the first molar followed by the second molar and in the maxillary than in the mandibular arch. Conclusions: No significant association was observed with the occurrence of pulp stones among patients with addictive habits, but a significant association was noted with respect to duration of habit.

Radiographic Assessment of Occurrence of Pulp Stones in Molars of Selected Adult Nepalese Populations at Tertiary Care Center

Background Pulp stones or “denticles” are a frequent finding in coronal and radicular pulp of primary and permanent dentition. These discrete calcified bodies can be seen in a healthy, diseased and sometimes even in an unerupted tooth. These calcifications are mostly present in molars as free, attached or embedded to dentine of pulp chamber or root canals.&#x0D; Objective To determine the occurrence of pulp stones in molars of selected adult Nepalese population using radiographs and assess the association of its occurrence gender and arch wise.&#x0D; Method A descriptive cross-sectional study was performed using orthopantomogram of total 380 patients (190 male and 190 females) of age group ranging from 16-30 years by convenience sampling. Data were collected through the examination of both hard and soft copies of radiographs under magnification. Pulp stones were scored as present or absent and their association with gender and dental arch were recorded. Descriptive statistics and chi square test was performed to see the prevalence and to compare the occurrence of pulp stone respectively.&#x0D; Result Out of 380 radiographic samples, pulp stones were present in 41.05% of the samples. The occurrence of pulp stones were found to be higher in females than in males, although the difference was not statistically significant (p=0.060).The total number of teeth with pulp stones was 238 and 61 in maxillary and mandibular arches respectively, with statistically significant difference (p&lt;0.001).&#x0D; Conclusion The overall occurrence of pulp stone was found to be 41.05%. It was observed more in females (45.78%) than in males (37%) and more frequently located in maxillary molars (29.2%) than in mandibular molars (8.2%).

Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia

Background: Urinary tract stones are common in patients with benign prostatic hyperplasia (BPH); therefore, an imaging test is needed for patients who have risk factors for the formation of urinary tract stones. The purpose of this study was to explore the factors associated with the presence of urinary tract stones in patients with BPH as information to conduct imaging tests.Methods: A cross-sectional quantitative analytic study was conducted on medical records of patients with BPH, both with and without urinary tract stones, or patients with urinary tract stones registered at the Department of Urology, Dr. Hasan Sadikin General Hospital, Indonesia, from 2015 to 2018. Data on age, body mass index, hypertension, use of antihypertensive drugs, diabetes mellitus, and hyperuricemia were collected and analyzed using the Mann-Whitney, Chi-square, Fisher exact test, and multivariate logistic regression statistical test to compare variables between BPH with and without urinary tract stones.Results: In total, 235 BPH patients were registered, of whom 74 (31.5%) had urinary tract stones. The median age was 64 years old. There was a relationship between age (p=0.030), diabetes mellitus (p=0.043), and the occurrence of urinary tract stones in patients with BPH. The most dominant risk factor was diabetes mellitus (OR=3.000, 95%CI 1.03-8.69).Conclusions: Age and diabetes mellitus are the risk factors for urinary tract stones in patients with BPH. BPH patients with diabetes mellitus are at a 3-fold risk for urinary tract stones. Diabetes mellitus in BPH patients is an indication to conduct imaging tests.

Genetic polymorphisms as prognostic factors for recurrent kidney stones: A systematic review and meta-analysis.

Genetic polymorphisms have been suggested as risk factors affecting the occurrence and recurrence of kidney stones, although findings regarding the latter remain inconclusive. We performed this systematic review and meta-analysis to clarify the associations between genetic polymorphisms and recurrent kidney stones. PubMed, SCOPUS, EMBASE, and Cochrane Library databases were searched through May 28th, 2020 to identify eligible studies. The Quality in prognostic studies (QUIPS) tool was used to evaluate bias risk. Allelic frequencies and different inheritance models were assessed. All analyses were performed using Review manager 5.4. A total of 14 studies were included for meta-analysis, assessing urokinase (ApaL1) and vitamin D receptor (VDR) (ApaI, BsmI, FokI, and TaqI) gene polymorphisms. The ApaLI polymorphism demonstrated protective association in the recessive model [odds ratio (OR) 0.45, P < 0.01] albeit higher risk among Caucasians in the heterozygous model (OR 16.03, P < 0.01). The VDR-ApaI polymorphism showed protective association in the dominant model (OR 0.60, P < 0.01). Among Asians, the VDR-FokI polymorphism recessive model showed significant positive association (OR 1.70, P < 0.01) and the VDR-TaqI polymorphism heterozygous model exhibited protective association (OR 0.72, P < 0.01). The VDR-BsmI polymorphism was not significantly associated with recurrent kidney stones in any model. Urokinase-ApaLI (recessive model), VDR-ApaI (dominant model), and VDR-TaqI (heterozygous model) polymorphisms were associated with decreased recurrent kidney stone risk whereas urokinase-ApaLI (heterozygous model) and VDR-FokI polymorphisms were associated with increased risk among Caucasians and Asians, respectively. These findings will assist in identifying individuals at risk of kidney stone recurrence.

Biliary tract exploration via left hepatic duct stump versus the common bile duct incision in left-sided hepatolithiasis: a meta-analysis.

Left lateral hepatic resection is the preferred surgical approach for treating left hepatolithiasis. However, it is not clear whether cholangioscopy via left hepatic duct (LHD) orifice can replace conventional common bile duct (CBD) approach during laparoscopic procedures. We performed a comprehensive literature search by screening medical databases, then compared perioperative outcomes and occurrence of recurrent stones between LHD and CBD approaches. A total of five studies, comprising 345 patients, were included in this meta-analysis. The reported operative times, intra-operative blood loss and incidence of post-operative complications were comparable between the approaches. Pooled results revealed a positive correlation between LHD approach with shorter length of hospital stay (standard mean difference=-1.36; 95% confidence interval: -2.10, -0.61; P < 0.001). Additionally, bile duct exploration via LHD orifice was associated with similar rate of recurrent stones and cholangitis across both groups. Our results demonstrated that biliary tract exploration via LHD stump can be safely performed in left-sided hepatolithiasis. Additionally, the LHD approach was associated with comparable intra-operative outcomes and shorter post-operative hospitalization relative to CBD approach, and does not increase incidence of stone recurrence.