7 research outputs found
Analysis of urinary calculi by physical methods in Hospital Universiti Sains Malaysia
No full textIn urolithiasis or kidney stone disease, research and in clinical practice the highly specific
and systematic analysis of urinary calculi is of great importance. The exact knowledge of
the type of the stone is a precondition of any medical therapy for urinary calculus.
Urolithiasis is a very frequent finding in the Kelantan, but stone analysis is not routinely
performed in HUSM.
Knowledge of the composition of calculi yields fundamental information concerning the
pathogenesis of the disease, including metabolic abnormalities, presence of infection,
possible artifacts, and even drug metabolism. Accurate high-quality urinary calculi analysis
is an essential requirement for this approach to patient management, allowing possible
causes to be defined, logical treatment strategies to be implemented and prevention of
stone recurrence.
Each method has merit in specific situations. Whereas a single method may not be
adequate for all analyses, a combination of methods used in a complementary fashion may
be relied on for accurate results. We therefore set out to analyze one hundred and fifty five
samples of urinary calculi in HUSM using the modem physicochemical methods, X-ray
diffraction, Fourier Transform Infrared Spectroscopy, Scanning electron microscopy and X-ray fluorescence which yield the best results in the differentiation of the constituents of
urinary calculi. The objectives of this study are to determine the composition of urinary calculi in HUSM
and correlate the urinary calculi composition using various techniques under physical
methods. Apart from that, we would also like to determine the association of demographic
features and location of the urinary stone formers. Last but not least, is to determine the
agreement between these four methods. We study the results, the reliability of these
methods and the important analytical tests for urinary calculi on identical stone material
under routine conditions. Through accurate high-quality urinary calculi analysis, allowing
logical treatment strategies to be implemented. This is an observational cross-sectional analytical study involves a total of one hundred
and fifty five urinary stone formers in HUSM which were collected from January 2003 to
December 2009. All stones removed from patients were placed in polyethylene dry bottles
labeled with the name, identification number, hospital registration number, sex, age, date
and ethnicity of the patient. The location of the stone and treatment were also recorded. Urinary calculi weighing more than 500mg were selected and prepared for the investigation. The specimens of urinary calculi were washed with distilled water, air-dried, finely ground and pressed into powder and divided into 4 samples and prepared for
analysis using Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM) and X-ray Fluorescence (XRF). All tests were performed at the Science Labs, School of Material and Mineral Resources Engineering,
Engineering Campus USM Transkrian Penang
Primary prostatic signet ring cell carcinoma in elderly with obstructive uropathy: a case report
No full textBackground: Primary signet-ring cell carcinoma (SRCC) of the prostate is a rare and aggressive subtype of prostate adenocarcinoma with a poor prognosis, with only approximately 60 cases reported worldwide. Case presentation: A 62-year-old man presented with acute urinary retention and hematuria, after a year’s history of lower urinary tract symptoms. Digital rectal examination revealed an irregular and hard prostate. Flexible cystoscopy showed bladder base infiltration by the enlarged prostate obscuring both ureteric orifices, necessitating nephrostomy and subsequent bilateral antegrade stenting to relieve the obstruction and improve his renal function. Transrectal ultrasonography biopsy of the prostate was performed revealing histological features of SRCC. Due to its rarity, there is currently no standardized treatment approach and it is often similarly treated according to the traditional management of prostate adenocarcinoma. Conclusions: SRCC of the prostate is a rare and aggressive subtype of acinar adenocarcinoma with no established guidelines. Histological criteria for SRCC of the prostate are highly variable in the available literature. It is important to differentiate between the primary and metastatic SRCC of the prostate as both are managed differently. However, the overall prognosis remains poor in general
Correlations between subdural empyema and paraclinical as well as clinical parameters amongst urban Malay pediatric patients
No full textPediatric subdural empyema are frequently seen in developing Asean
countries secondary to rinosinusogenic origins. A cross sectional
analysis on the surgical treatment of intracranial subdural empyema
(PISDE) in Hospital Kuala Lumpur (HKL), a major referral center, was
done in the period of 2004. A total number of 44 children who fulfilled
the inclusion criteria were included into this study. The methods of
first surgery, volume of empyema on contrasted CT brain, improvement of
neurological status, re-surgery, mortality and morbidity, as well as
the demographic data such as age, gender, sex, duration of illness,
clinical presentation, probable origin of empyema, cultures and
follow-up were studied. Chi-square test was performed to determine the
association between surgical methods and the survival of the patients,
neurological improvement, clearance of empyema on CT brain, re-surgery
and long morbidity among the survivors. If the 20% or more of the cells
were having expected frequency less than five, then Fisher’s
Exact test was applied. The level of significance was set at 0.05. SPSS
version 12.0 was used for data entry and data analysis.There were 44
patients who were less than 18 years. Their mean age was 5.90 ±
6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved
in the study. Malays were majority with 28 (63.6%) followed by Indian 8
(18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which
were under interest were gender, race, headache, vomiting, seizures,
sign of meningism, cranial nerve palsy, thickness site of abscess,
first surgical treatment, improvement in neurological deficit,
clearance of CT and whether re-surgery was necessary. All variables
were found not to be associated with Henk W Mauser Score for PISDE
grading. Comparison between this urban study and a rural setting study
by the same corresponding author in the same period on subdural empyema
was done. Common parameters were compared and it was found out that
seizures was more prevalent in urban study where the patients were more
than one year old (p=0.005). Mortality was much higher in urban study
than the rural one (p=0.040). The larger proportion of urban group had
volume of abscess less than or equal to 50 ml (p=< 0.001)
Correlations between subdural empyema and paraclinical as well as clinical parameters amongst urban Malay paediatric patients
No full textPaediatric subdural empyema is frequently seen in developing Asean countries secondary to rinosinusogenic origins. A cross-sectional analysis on the surgical treatment of intracranial subdural empyema in Hospital Kuala Lumpur (HKL), a major referral center, was done in 2004. A total number of 44 children who fulfilled the inclusion criteria were included into this study. The methods of first surgery, volume of empyema on contrasted CT brain, improvement of neurological status, re-surgery, mortality and morbidity, as well as the demographic data such as age, gender, sex, duration of illness, clinical presentation, probable origin of empyema, cultures and follow-up were studied. Chi-square test was performed to determine the association between surgical methods and the survival of the patients, neurological improvement, clearance of empyema on CT brain, re-surgery and long morbidity among the survivors. If the 20% or more of the cells were having expected frequency less than five, then Fisher’s Exact test was applied. The level of significance was set at 0.05. SPSS version 12.0 was used for data entry and data analysis. There were 44 patients who were less than 18 years. Their mean age was 5.90 ± 6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved in the study. Malays were majority with 28 (63.6%) followed by Indian 8 (18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which were under interest were gender, race, headache, vomiting, seizures, sign of meningism, cranial nerve palsy, thickness site of abscess, first surgical treatment, improvement in neurological deficit, clearance of CT and whether re-surgery was necessary. All variables were found not to be associated with Henk W Mauser Score for PISDE grading. Comparison between this urban study and a rural setting study by the same corresponding author in the same period on subdural empyema was done. Common parameters were compared and it was found out that seizures were more prevalent in urban study where the patients are more than one year old (p=0.005). Mortality was much higher in urban study than the rural one (p=0.040). The larger proportion of urban group had volume of abscess less than or equal to 50 ml (p=< 0.001)
Correlations between subdural empyema and paraclinical as well as clinical parameters amongst urban Malay pediatric patients
No full textPediatric subdural empyema are frequently seen in developing Asean
countries secondary to rinosinusogenic origins. A cross sectional
analysis on the surgical treatment of intracranial subdural empyema
(PISDE) in Hospital Kuala Lumpur (HKL), a major referral center, was
done in the period of 2004. A total number of 44 children who fulfilled
the inclusion criteria were included into this study. The methods of
first surgery, volume of empyema on contrasted CT brain, improvement of
neurological status, re-surgery, mortality and morbidity, as well as
the demographic data such as age, gender, sex, duration of illness,
clinical presentation, probable origin of empyema, cultures and
follow-up were studied. Chi-square test was performed to determine the
association between surgical methods and the survival of the patients,
neurological improvement, clearance of empyema on CT brain, re-surgery
and long morbidity among the survivors. If the 20% or more of the cells
were having expected frequency less than five, then Fisher’s
Exact test was applied. The level of significance was set at 0.05. SPSS
version 12.0 was used for data entry and data analysis.There were 44
patients who were less than 18 years. Their mean age was 5.90 ±
6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved
in the study. Malays were majority with 28 (63.6%) followed by Indian 8
(18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which
were under interest were gender, race, headache, vomiting, seizures,
sign of meningism, cranial nerve palsy, thickness site of abscess,
first surgical treatment, improvement in neurological deficit,
clearance of CT and whether re-surgery was necessary. All variables
were found not to be associated with Henk W Mauser Score for PISDE
grading. Comparison between this urban study and a rural setting study
by the same corresponding author in the same period on subdural empyema
was done. Common parameters were compared and it was found out that
seizures was more prevalent in urban study where the patients were more
than one year old (p=0.005). Mortality was much higher in urban study
than the rural one (p=0.040). The larger proportion of urban group had
volume of abscess less than or equal to 50 ml (p=< 0.001)
Exercise-induced ruptured renal tumour in a young patient with hereditary leiomyomata-associated renal cell carcinoma (HLRCC): a case report
No full textBackground: Hereditary leiomyomatosis-associated renal cell carcinoma (HLRCC) is rare with only 300 families reported to date worldwide. Despite highlighting renal malignancy, it is infamous for its cutaneous and leiomyomatosis component as the more common cause of presentation. This report is to highlight the rare presentation of HLRCC which occurs in a teenager which is unfortunately complicated with exercise-induced renal tumour rupture. Case presentation: A 22-year-old gentleman presented with severe right lower abdominal pain for 4 days, associated with fever and nausea following a session of strenuous exercise. He has frst-degree relatives and second-degree relatives from his maternal side who were genetically tested positive for HLRCC. Clinical examination revealed a tender right lumbar and right iliac fossa region. A computed tomography of the kidneys demonstrated a ruptured right renal tumour with a large right renal subcapsular and contained right retroperitoneal hematoma. An emergency right radical nephrectomy was performed, and he recovered well. The histopathological examination was consistent with HLRCC associated ruptured right renal cell carcinoma. Conclusion: Identifcation of this underreported familial malignancy is paramount as the onset of neoplasia occurs much earlier in life. This necessitates screening of family members at a younger age, and the management is followed by life-long surveillance
Off-the-Shelf Implant to Bridge a Urethral Defect: Multicenter 8-Year Journey From Bench to Bed
No full textObjective: To engineer an acellular mesh to reconstruct the urethra to replace the current surgical practice of using autologous tissue grafts. Cell based approaches have shown progress. However, these have been associated with high costs and logistical challenges. Materials and Methods: Acellular meshes were engineered using liquid collagen. They underwent in vitro, mechanical and bench testing by surgeons. Sixty-nine male New Zealand rabbits were used to refine the design. The final prototype based on the TissueSpan patented technology was then implanted again in a 2 cm long urethral defect in 9 rabbits and in a 4 cm long defect in 6 dogs. Results: The TissueSpan technology platform allows for the manufacturing of tubular and rectangular meshes in different diameters and thicknesses. The tubular mesh acted as physical conduit to gap the urethral defect with a patent urethra demonstrated after 1 month in both animal models. The mesh was absorbed within 1-3 months. Spontaneous urothelial coverage of the mesh and smooth muscle cell migration into the surgical area was demonstrated even in a 4 cm long urethral defect. A first in man clinical trial was subsequently initiated. Conclusion: The acellular mesh may have the potential to be an off-the-shelf product for substitution urethroplasty. Its mechanical properties allow surgeons to easily create a physical conduit while its material properties favor tissue remodeling. A large-scale clinical trial is still required to further confirm the safety, performance, and patient benefit of this new medical device.SSV-EN
