Karthick, Chandran (2020) Calculous Disease of the Urinary Tract: A Clinical and Epidemiological study at Chengalpattu Medical College. Masters thesis, Chengalpattu Medical College and Hospital, Chengalpattu.
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Abstract
BACKGROUND: Urolithiasis is one of the most common clinical conditions, a clinician is likely to encounter in his/her practice. The Urolithiasis patient may test the diagnostic skill of a practitioner and the subsequent evaluation of the patient may be a very tough test for his/her knowledge and experience. Though the composition of the calculus and treatment protocols might have changed recently, archaeologic studies show the urinary tract stone disease was always a problem for humans earlier than 4600 B.C. This is a study of 162 patients with calculous disease of the urinary tract seen during the period of 1 year, from April 2018 to April 2019 with reference to epidemiological workup and the clinical evaluation, along with complete and thorough clinical examination, plain X-ray KUB, Ultrasound KUB, Intra Venous Urethrogram, Blood investigations, Stone analysis and urine examination which includes both urine routine and urine culture and sensitivity. The present study deals with epidemiology of urolithiasis, their distribution along urinary tract along with the supporting Investigations to confirm the diagnosis and then later to arrive at a decision-making process for the treatment modality at different levels. AIM AND OBJECTIVES: To evaluate all these patients with calculous disease of the urinary tract with reference to its clinical epidemiology including: i. Age and Sex, ii. Hereditary / Metabolic diseases if any, iii. Environmental factors, iv. Urinary tract infection, v. Dietary factors if any, vi. Distribution of calculi within the urinary tract. To clinically evaluate all patients with complete and thorough clinical examination, their usual modes of presentation, along with associated urological problems and other comorbidities if any and then thoroughly investigating them to arrive at a decision as to how to treat them. To study various modalities of treatment offered at different levels of calculous impaction and finally the stone analysis of the stones retrieved by medical as well as surgical management. DURATION OF STUDY: One Year (April 2018- April 2019). POPULATION TO BE STUDIED: 162. STUDY SETTING: Outpatients and Inpatients of Department of General Surgery and Inpatients of Department of Urology, Chengalpattu Medical College and Hospital, Chengalpattu. STUDY DESIGN: Prospective and Retrospective study. MATERIALS AND METHODS: The present study involves a total of 162 patients with calculous disease to the urinary tract observed during the period of 1 year, from April 2018 to April 2019. The study was conducted both by prospective as well as by retrospective methods, by analysing the case sheets on a random basis. All patients of prospective study were followed up in speciality department, where they were subjected to a detailed clinical and epidemiological workup. Complete Blood count, urinalysis, urine culture, serum biochemistry, X ray KUB were performed in all cases. Chemical analysis of stones was performed in 39 cases postoperatively after stone retrieval by surgeries. Radiological investigations included plain x-ray KUB, ultrasound IVU series, CT if needed, depending on clinical situation were done. Ultrasound KUB was performed while endoscopic procedures were usually undertaken for therapeutic reasons. EXCLUSION CRITERIA: • Paediatric age group was excluded as they were referred directly to childrens hospital from the OPD/ER. • Cases directly attending to the speciality outpatient department Could not be included in the present study. CONCLUSION: • To find out the age and sex incidence of Urolithiasis is predominantly a disease. • To find out Metabolic disorders if any. • To find out an association between stone disease and environment. • To find out an association between stone disease and people with decreased fluid intake. • To find out the Risk of Urinary tract infection in patients with stones and to find out the most common organism associated with stones. • To find out the most common site of stones and to see if there is any preponderance to laterality. • To find out the most common site of obstruction of stones. • To find the most common presenting symptom of stones • To find out if there is any associated urological condition leading to stone formation. • To find out the most common investigation used to diagnose urinary stones and to find its specificity. • To discuss the most common treatment modalities in detail and to arrive at a decision regarding the management process. • To find out the major constituents of stones.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711257 |
| Uncontrolled Keywords: | Calculous Disease, Urinary Tract, Clinical and Epidemiological study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 17:16 |
| Last Modified: | 10 Feb 2021 17:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14005 |
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