31.12.37 A Study on Urinary Tract Infection and Metabolic Diseases in Stone Patients

Article

 

UTI and Metabolic Diseases in Stone Patients

A Study on Urinary Tract Infection and Metabolic Diseases in Stone Patients

Syed Muhammad Hassan Akhtar1, Aftab Ahmad Channa2 and Nadeem Shafiq2

                                                   ABSTRACT

Objective: The main objective of the study is to analyze the Urinary Tract Infection and metabolic diseases in Stone Patients among local population of Sialkot.

Study Design: Cross Sectional Study

Place and Duration of Study: This study was conducted at the Allama Iqbal Memorial Teaching Hospital, Sialkot during June 2018 to June 2019.

Materials and Methods: The definite history of the multitude of patients were accumulated and 24 hour p-test was gathered from every patient and sent for PH, explicit gravity, Creatinine, uric corrosive, calcium, phosphate, oxalate, citrate and magnesium. 24 hour p-tests were gathered in plastic boxes, which don't respond artificially by standard techniques, and were put away at 2-8ºC. Likewise, blood test of every patient was additionally sent for serum levels of urea, creatinine, uric corrosive, phosphate and calcium.

Results: The data were collected from 100 patients with the mean age 38 ± 7.75 years. There were 35 male and 65 female patients who were selected this investigation. The primary introducing grievance was amble torment on the influenced side for example in 79.0% patients, trailed by hematuria and consuming micturition. Dominant part of the patients for example 94.0%, were analyzed as having renal stone or ureteric stone.

Conclusion: It is concluded that recurrence of metabolic variations from the norm is exceptionally high in patients with urolithiasis and hyperoxaluria, hypercalciuria and hypocitraturia are the main metabolic irregularities saw in these patients. Stone sickness is an expanding and significant general health issue with high recurrence of bladder stone.

Key Words: Urinary, Tract, Infection, Patients, Metabolic

Citation of article: Akhtar SMH, Channa AA, Shafiq N. A Study on Urinary Tract Infection and Metabolic Diseases in Stone Patients. Med Forum 2020;31(12):157-160.

 

 

INTRODUCTION

Urolithiasis is a disease which is common now a days in the whole world. It is assessed that roughly 2% of the populace experience renal stone illness at times in their existence with top rate in second and third many years of life. There are a few sorts of urinary stones, and they are ordered by compound composition1. Calcium oxalate is the significant segment of by far most of stones. A few components, for example, age, sexual orientation, atmosphere, metabolic variations from the

 

 

1. Department of Urology, Government Khawaja Muhammad Safdar Medical College, Sialkot.

2. Department of Urology, Islam Medical and Dental College, Sialkot.

 

 

Correspondence: Dr. Syed Muhammad Hassan Akhtar, Assistant Professor of Urology at Government Khawaja Muhammad Safdar Medical College, Sialkot.

Contact No: 03338624887

Email: dsmhau@gmail.com

 

 

Received:    May, 2020

Accepted:    September, 2020

Printed:        December, 2020

 

 

 

 

 

 

 

norm and heredity, are related to the improvement of urinary stones. Metabolic variations from the norm are the main elements since they can be altered to forestall the danger of urinary stones2.

Inhabiting urinary catheters are standard clinical gadgets used in both clinic and nursing home settings to mitigate urinary maintenance and urinary incontinence3. Of the very nearly 100 million catheters that are sold yearly around the world, one-fourth of them are sold in the United States4. The most widely recognized urinary catheter being used is the Foley inhabiting urethral catheter, a shut sterile framework that is included a cylinder embedded through the urethra and held set up by an inflatable to permit urinary seepage of the bladder5. In spite of the fact that these gadgets were initially intended for transient use in patients, inhabiting catheter use is currently typical in the long haul setting6. Infections of the urinary tract related with catheter use are huge not just due their high frequency and ensuing financial expense yet additionally on account of the serious sequelae that can result7.

Patients with confounded UTI should be treated by compelling antimicrobial treatment just as suitable urological mediation to eliminate inclining factors when the manifestations are related, for example, micturition torment, dysuria, urinary recurrence, and low or high fever8. Paradoxically, asymptomatic bacteriuria (ASB) is recognized by segregation of a predetermined quantifiable measure of microorganisms in a properly gathered urine example acquired from a patient without indications or signs referable to urinary infection9.

MATERIALS AND METHODS

This cross sectional study was conducted at Allama Iqbal Memorial Teaching Hospital, Sialkot during June 2018 to June 2019. The data was collected from 100 patients of both genders. The data was gathered through non probability sampling technique.

Inclusion criteria: Patients with one or the other various or repetitive urolithiasis were remembered for this investigation.

Exclusion criteria: Patients with some other sickness were prohibited from this examination.

Patients with ongoing renal disappointment, persistent liver sickness and with history of any constant medication use were rejected.

Data collection: The data were collected from 100 patients. The positive history of the large number of patients were collected and 24 hour urine test was assembled from each patient and sent for PH, express gravity, Creatinine, uric acid, calcium, phosphate, oxalate, citrate and magnesium. 24 hour urinetests were accumulated in plastic boxes, which don't react misleadingly by standard procedures, and were taken care of at 2-8ºC. Moreover, blood trial of each patient was furthermore sent for serum levels of urea, creatinine, uric destructive, phosphate and calcium. The serum levels of metabolic limits were assessed by standard compound strategy. All patients by then had legitimate method after fulfillment of all workup and stones were transported off pathology research office for compound assessment to consider the stone structure.

The data were collected and analyzed through SPSS (Version 21.0). All the values were expressed in mean and standard deviation.

RESULTS

The data were collected from 100 patients with the mean age 38 ± 7.75 years. There were 35 male and 65 female patients who were selected this investigation. The primary introducing grievance was amble torment on the influenced side for example in 79.0% patients, trailed by hematuria and consuming micturition. Dominant part of the patients for example 94.0%, were analyzed as having renal stone or ureteric stone. Just 38.0% patients gave intermittent stones while staying 62.0% had stone unexpectedly. Substance examination of stones after complete strategy had demonstrated calcium oxalate stone in 82.5% patients (table 01).

 

Table No.1: Descriptive statistics for different variables

Features

%age

Presenting Complaint:

 
  • Lumber pain
  • Hematuria
  • Burning micturation

79.0
13.0
8.0

Diagnosis:

 
  • Renal stone
  • Ureteric stone
  • Renal + Ureteric stone
  • Urinary bladder stone

63.0
21.0
10.06.0

Recurrent stone:

 
  • Yes
  • No

38.0
62.0

Family history of Urolithiasis:

 
  • Yes
  • No

64.0
36.0

Stone composition on Stone analysis:

 
  • Calcium oxalate
  • Calcium phosphate
  • Uric acid
  • Struvite
  • Cystine

82.5
2.5
11.5
1.5
2.0

Hyperoxaluria was the most commonly observed metabolic abnormality and was found in 12 patients. Other significant metabolic abnormalities were hypercalciuria, Hypercalcemia, hypocitraturia and hyperuricemia (table 2).

Table No.2: Frequency of Metabolic diseases in selected participants

Metabolic abnormality

Frequency

%age

Hyperoxaluria (oxalate > 45 mg/d)

12

12.1

Hypercalciuria (> 250 mg/d for women and > 300 mg/d for men)

17

16.9

Hypocitraturia (citrate levels < 320 mg/d)

11

11.2

Hypernatriuria (sodium level > 220 mmol/ day)

19

18.8

Hyperuricosuria ( > 600 mg/d in women and > 750 mg/d in men)

3

3.0

Hypomagnesuria (magnesium level < 3 mg/day)

8

7.9

Hyperphosphaturia (phosphate level > 1.3 g/day)

13

13.1

Hypercalcemia (calcium above the normal range i.e. 8.4-10.2 mg/dl):

5

5.0

Hyperuricemia: (normal range 2.5-8 mg/dL for males and 1.5-6.0 mg/dL for females).

9

9.0

 

 

 

DISCUSSION

Urinary stones in its various structures are the third most basic difficulty of the urinary tract. Math illness is the commonest urological sickness in Sialkot. It has been evident for quite a long while that the occurrence paces of lithiasis shift significantly, from mainland to landmass as well as between neighboring areas of a nation, regardless of whether one takes into consideration contrasts in technique and models determination among the study of disease transmission studies9. The lifetime pervasiveness of urinary stones has expanded all through the twentieth century and happens in up to 15% of the populace. It is commonly acknowledged that stones happen more ordinarily in guys than females10. Our discoveries certify with this sex contrast as announced by others. No age bunch is saved to urinary stone illness in Sialkot however an adjustment in the age example of patients of urolithiasis has been accounted for in industrialized countries11. In our examination, the primary introducing grumbling was blunder torment for example in 79.0% patients. Elfadil GA et al had likewise discovered flank torment as the head introducing grievance in his investigation for example in 67% patients5. The consequences of our investigation have demonstrated a solid hereditary inclination to urinary stone infection as 64.0% patients had family background of urolithiasis. This hereditary factor is additionally upheld by investigations of Majalan NN et al8 who had discovered a positive family ancestry in 67.0% and 53.1% patient's respectively. Then again, Elfadil GA et al5 had discovered this in just 20% of their patients. We had additionally discovered 38.0% patients with intermittent urinary stones and the significant stone segment was calcium oxalate in our examination which was likewise found by Elfadil GA et al.5 But in an investigation by Androulakakis et al, the primary segments of urinary stones in Europe, in diminishing request, are struvite, calcium phosphate and calcium oxalate10.

In our investigation, metabolic anomalies were found in 90.5% patients, while there was no metabolic variation from the norm in just 9.5% patients which is a lot of practically identical to numerous past examinations. In an investigation by other study, 62.2% of patients had various metabolic variations from the norm; in any case, the patients didn't have repetitive calcium oxalate stones12. Accordingly, it very well may be assumed that numerous metabolic anomalies are more normal in patients with intermittent calcium oxalate stones13-15.

CONCLUSION

It is concluded that recurrence of metabolic variations from the norm is exceptionally high in patients with urolithiasis and hyperoxaluria, hypercalciuria and hypocitraturia are the main metabolic irregularities saw in these patients. Stone sickness is an expanding and significant general health issue with high recurrence of bladder stone.

Author’s Contribution:

Concept & Design of Study:

Syed Muhammad Hassan Akhtar

Drafting:

Aftab Ahmad Channa

Data Analysis:

Nadeem Shafiq

Revisiting Critically:

Syed Muhammad Hassan Akhtar, Aftab Ahmad Channa

Final Approval of version:

Syed Muhammad Hassan Akhtar

Conflict of Interest: The study has no conflict of interest to declare by any author.

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