Estimation of blood loss in transurethral resection of prostate (TUR-P) by urine-strip.

OBJECTIVES: Blood loss in transurethral resection ofprostate (TUR-P) operation is estimated by the difference between pre- and post-operative hemoglobin (Hb) concentration. The authors introduced a novel practical method to estimate blood loss in the patients who were surgically managed with TUR-P operation. MATERIAL AND METHOD: Complete blood count was collected pre-operative, immediate post-operative, and 24-hour post-operative to determine red blood cells and Hb concentration. Hemoglobin of irrigating fluid was measured by standard spectrophotometry and blood loss was estimated by the authors' calculation. Irrigating fluid was frozen and thawed to completely hemolyse the red blood cells, then it was tested by urine-strips and calculated for red cells using estimating cell ranges given by the product's prescription. The correlation between these indicators was evaluated. RESULTS: Calculated blood loss detected by spectrophotometric method has no correlation with immediate post-operative or 24-hour post-operative Hb concentration. However, it had a significant positive correlation with calculated blood loss by urine-strip technique (r = 0.897, p = 0.01). CONCLUSION: Urine-strip method can be used to estimate total blood loss in irrigating fluid in patients with TUR-P operation. This is practical and useful in immediate post-operative evaluation of blood loss to consider the need of blood transfusion.

Crystalline composition and etiologic factors of kidney stone in Thailand : update 2007.

Objective: The etiology of kidney stone is multifactorial including environmental, behavioral and genetic. Insights about predisposing causes and mineral composition are mandatory for better management of kidney stone disease. The present hospital-based study aims to explore the mineral constituents and etiologic risks of kidney stones in Thai patients from the four geographic regions of the country. Method: Two hundred and fifty six kidney stone patients from four geographic regions of Thailand, including the northeastern (n=103), the northern (n=81), the central (n=47) and the southern (n=25) were recruited in this study. Of these, 144 patients completed the food frequency questionnaire to assess the kidney stone risk. Mineral composition of stones were analyzed by Fourier transformed infrared spectrometry. Results: Kidney stone frequently affected peoples aged 40-49 years. Only 31.9 % of patients had a positive family history of renal stone. Calcium oxalate (CaOx) stone was the most prevalent type (73.8 %). Uric acid (UA) stone was found in 16.0 % commonly affected peoples aged 60-70 years. Mixed stones, notably CaOx mixed with calcium phosphate (CaP), were more prevalent than pure stones. The food frequency questionnaire data showed that 59.7 % of stone patients consumed less than two liters of water per day. Low intakes of fruits and vegetables were notably present. In contrast, high consumption of rice was observed in over 65 % of stone patients. Conclusion: CaOx mixed with CaP was the most prevalent stone type. UA stone was more likely to occur in the elderly. Kidney stone patients were found to consume less-than-adequate amounts of water, food high in carbohydrates, along with low consumtion of fruits and vegetables. These dietary habits might be risk factors in stone development among the Thai population.

The benefits of vitamin C and vitamin E in children with beta-thalassemia with high oxidative stress.

The present study aimed to determine the benefits of vitamin C and vitamin E as antioxidant supplements in beta-Thalassemia children who are at risk of iron overload due to multiple blood transfusion and high oxidative stress. Antioxidant status, oxidative products, plasma free hemoglobin, total hemoglobin and bilirubin were discussed. Twenty children who had laboratory confirmation of major beta-Thalassemia at least 6 months with history of packed red cell transfusion without iron chelation were recruited. The informed consent for blood sample collection and antioxidant medication was performed. Most patients (85%) had hyperferritinemia and all of them had high oxidative stress. All of them had low vitamin C and vitamin E level at recruitment. Three months after vitamin C and vitamin E supplementation, plasma vitamin C, vitamin E and glutathione were significantly increased, while total bilirubin was slightly decreased without significance. Other parameters included total antioxidant status (TAS), plasma and erythrocyte malondialdehyde (MDA), hemoglobin and plasma free hemoglobin had no differences during the study period. CONCLUSION: B-Thalassemia major children who had multiple blood transfusion are at risk in iron overload and high oxidative stress. From the present study, no significant improvement in raising hemoglobin and concerning low dose vitamin C is not contraindication in beta-Thalassemia patients. Therefore, vitamin C plus vitamin E supplementation have benefits more than vitamin E alone in promoting antioxidant status and may enhance liver function as total bilirubin tends to decrease.