Congenital megalourethra.

Congenital non-obstructive dilatation of penile urethra (megalourethra) can result from absence of corpus spongiosum alone (scaphoid) or along with the absence of corpora cavernosa (fusiform). Associated urogenital or other systemic anomalies are usually present and require detection and appropriate management. Urethroplasty (Nesbitt) gives desirable results. Condition has been reviewed with report of a case.

Wilm's tumour with WAGR complex.

WAGR Syndrome is an acronym for a rare constellation of congenital abnormalities which include Wilms' tumor, Aniridia, Genito-urinary malformations and mental Retardation. Fewer than fifty patients of this complex have been described in the literature. We report a case of WAGR syndrome, with Stage-IV Wilms' tumor and intracaval extension, treated by multimodal therapy.

Nutrition and urinary calcium stone formation in northwestern India: a case control study.

The nutrient intake of 69 stone formers (SFs) from three subsets of the local population (urban 22, rural tribal 22 and rural nontribal 25) and 69 age, sex, weight and socioeconomically matched control subjects (NSs) (urban 20, rural tribal 22 and rural nontribal 27) was studied. Simultaneously their times 24-h urine samples collected over a similar period were analyzed. In general caloric and protein intake was low in all the groups but was strikingly low in the rural subjects. Intake of all nutrients was lowest in the tribal group. Although no difference was observed in diet between NSs and SFs in the same population subjects. SFs had higher urinary excretion of oxalic acid and calcium and lower excretion of citric acid and excreted more saturated urine. Notably magnesium intake was normal in both NSs and SFs, but mean excretion of magnesium was lower than normal in all the groups, suggesting its defective absorption. The influence of dietary intake of protein, carbohydrate, fat, fiber, calcium and oxalic acid on urinary excretion of calcium, oxalic acid, uric acid, inorganic phosphorus, magnesium and citric acid was examined using the chi-square test. No association was observed, thus suggesting that this low nutrient intake did not influence the lithogenic process. Thus, the overall observations suggest: (a) poor nutrition, (b) no effect of diet on urinary stone disease, (c) no difference in the nutrient intake between NSs and SFs and (d) a higher excretion of promoters and a lower excretion of inhibitors in SFs than in NSs.

A study of recurrent stone formers with special reference to renal tubular acidosis.

Forty-five patients with recurrent renal stone were examined for distal renal tubular acidosis (dRTA) defects by acid challenge test (150 mg ammonium chloride/kg body weight). Their 24-h urine samples were analysed for creatinine, calcium, oxalic acid, inorganic phosphorus, uric acid, magnesium and citric acid. One-hour urine samples before acid load and hourly samples for the 7 h following acid challenge test were collected and analysed for creatinine, calcium, citric acid, inorganic phosphorus, titratable acidity, and ammonium. The incidence of distal RTA defect was 22.2% in the patients examined. The major biochemical characteristics in RTA patients compared with patients without RTA were: (a) significantly higher urinary pH, (b) significantly lower excretion of citric acid, (c) no significant difference in calcium excretion and (d) a tendency toward lower titratable acidity and ammonium excretion.

Ascorbic acid is an abettor in calcium urolithiasis: an experimental study.

Two sets of animal experiments using guinea pigs were planned to evaluate the effect of ascorbic acid supplementation on the lithogenic process. In the first set of experiments, 10, 40, and 60 mg doses of ascorbic acid/100g body weight/day were given for 105 days. Neither of the ascorbic acid doses given induced crystalluria, calcification or stone formation, thereby confirming our previous findings that ascorbic acid in the doses used by clinicians does not cause urolith formation. In the second set of experiments, ascorbic acid was supplemented in hypercalciuric (induced by calcium carbonate feeding) and hyperoxaluric (induced by sodium oxalate feeding) animals for 45 days. The results indicated that it exacerbated the calcification process in renal and bladder tissue.

Effectiveness of a unani therapy (sangesarmahi) in management of urinary stone disease.

A Unani medicine called fish stones, an isolate from the skull of Channa sp. when given to stone bearing patient daily in 3 equally divided doses (25 mg/capsule) for 5 days, spontaneously voided the stone in 36% of the stone patients during 5 days of therapy. The therapy did not influence the urinary chemistry and was not a powerful expulsion agent of stone but did effect on ureteric muscles to facilitate the movement of stone down the urinary tract. In guinea pigs, the therapy could not reduce the intensity of experimentally induced hyperoxaluria but showed several other beneficial effects. It decreased urinary uric acid and mucoprotein levels, serum LDH and ALT level; prevented rise in liver LDH and GAO activities and kidney-LDH activity. Histological examination revealed decreased intensity of calcification in liver, kidney and bladder tissues.

Topical phenytoin in wound healing.

BACKGROUND: Phenytoin, introduced in 1937 as an antiseizure medication, has since been reported to promote wound healing when applied as a topical agent. This study was undertaken to evaluate its effectiveness in chronic skin ulcers. METHODS: Seventy-five inpatients with chronic skin ulcers were included in this controlled trial. Forty patients were treated with topical phenytoin, and 35 patients with conventional saline dressings. Assessment of the wounds included wound area, bacteriologic cultures, and clinical assessment by blind observers at baseline and every 7 days thereafter over the 4-week treatment period. RESULTS: Wound area reduction was greater in the phenytoin group than in controls. Fifty percent of phenytoin-treated wounds had negative cultures by day 7, compared to 17% of controls. Healthy granulation tissue appeared earlier with phenytoin. At the end of the fourth week, 29 of 40 phenytoin-treated ulcers had healed completely versus 10 of 35 controls. CONCLUSIONS: Topical phenytoin appears to be an effective, inexpensive, and widely available therapeutic agent in wound healing. Further clinical use and evaluation is merited.

Effect of dietary methionine and inorganic sulfate with and without calcium supplementation, on urinary calcium excretion of guinea pigs (Cavia porcellus).

Supplementation of sodium sulfate and DL-methionine along with the standard diet to guinea pigs nearly doubled the urinary calcium in 6 weeks. This was probably due to decreased tubular reabsorption of calcium which was complexed with sulfate in the tubular lumen. A mild calcium load didn't further enhance calcium excretion in sodium sulfate supplemented group, but did so in methionine supplemented group. It may be due to methionine which might have increased the intestinal absorption of calcium. Both of these compounds increased citric acid excretion and decreased magnesium excretion.

Effect of dietary salt (NaCl) supplementation on urinary profile of guinea pigs (Cavia porcellus).

Sodium chloride supplementation (120 mg/kg of body weight/day) for 12 days increased the urinary excretion of calcium from 91.6 +/- 9.0 to 159.4 +/- 16.0 mumol/day and of sulphate from 266.8 +/- 24.5 to 1176.9 +/- 87.2 mumol/day in guinea pigs. The stone risk due to increased urinary calcium excretion could possibly be counterbalanced by increasing urinary sulphate excretion. High salt intake, thus, could not increase the risk of stone formation.

Hashimoto's thyroiditis--a clinical review.

Hashimoto's thyroiditis constituted 5.15% of total thyroid disorders examined from January 1983 to July 1987. Females were predominant sufferers. Average age of patients was 41.14 years. Functionally 10 patients were euthyroid, while hyperthyroidism was present in 4 cases. Its preoperative diagnosis was not possible in any of the case. All patients were subjected to surgery and postoperative thyroxine supplement.

Zinc, copper and manganese in serum, urine and stones.

Serum zinc, copper and manganese levels were estimated in normal subjects (NS) and stone formers (SF). There was no significant difference in the serum levels of Zn, Cu, and Mn in NS and SF, the values being 101.5 +/- 35.1 micrograms% and 94.3 +/- 45.6 for Zn; 91.75 +/- 27.0 micrograms% and 88.5 +/- 34.1 for Cu; and 87.0 +/- 36.7 micrograms% and 79.6 +/- 35.5 for Mn, respectively. Zinc excretion was relatively high in NS (790.08 +/- 172.88 micrograms/dl) as compared to other populations and was significantly higher in SF (1154.92 +/- 290.17 micrograms%, p less than 0.001). Copper and manganese excretions in SF were significantly lower than in NS (p less than 0.001). Zinc was present in substantial quantities in renal (2.52 +/- 3.98 g%), ureteric (0.75 +/- 0.51 g%) and vesical (1.71 +/- 3.20 g%) stones. Manganese was present in traces in all the stones and copper in two-thirds of the stones.

Interdependence of urinary factors in calcareous bladder stone patients.

Twenty-four-hour urinary excretion of calcium, oxalic acid, inorganic phosphorus, magnesium and citric acid was examined in fifty-nine stone formers with bladder stones. Hypercalciuria and hyperoxaluria were present in 18.6% and 44.1%, respectively, while 11.9% of patients had both abnormalities. Hypomagnesuria and hypocitraturia were present in 67.8% and 69.5%, respectively, while 45.7% had both of these abnormalities. Normal urine chemistry in respect of parameters studied was observed only in 1.7% of cases. In 15.2% one risk factor was present, while 83.1% had two or more risk factors. "Path" analysis of the urinary parameters directly related to calcium lithiasis showed that magnesium and oxalic acid have substantial influence on calcium excretion, whereas citric acid had none. The influence of phosphorus did not provide any consistent trend.

Urinary biochemical profile of patients with ureteric calculi in Jodhpur region (north western India).

Urine chemistry of 42 normal subjects (NS) and 59 ureteric stone formers (SF) from Jodhpur region of Rajasthan, India is presented. Twenty four hour urinary levels of calcium, oxalic acid and uromucoids were significantly higher and levels of magnesium, citric acid and inorganic phosphorus were significantly lower in SF as compared to NS. No significant difference was observed in the uric acid, sodium and potassium levels in the two groups. Significant correlation was observed between calcium and magnesium; calcium and oxalic acid; calcium and citric acid; magnesium and oxalic acid; and oxalic acid and citric acid in NS on the basis of mmol/l but not on the basis of mmol/24 h. Calcium and oxalic acid correlation was uninfluenced by magnesium and citric acid levels. The log of risk factor index (RI) was higher (p less than 0.001) in SF (-1.652) as compared to NS (-2.103). The log of ion activity product (IAP) was also higher (p less than 0.001) in SF (-3.192 X 10(-3)) than in NS (-2.914 X 10(-1)). Based on RI and IAP, a scale has been devised for the prediction of the risk of stone formation and recurrence.