ABSTRACT
BACKGROUND: Leprosy in children is a strong indicator of the recent failure of leprosy control and disease transmission programs. For twenty-two years, leprosy has been declared `eliminated as a public health hazard,` yet new cases continue to emerge in endemic areas. The new case detection rate among the child population was recorded at 4.4 per million children. Because of their underdeveloped or neonatal immunity and exposure to intrafamilial contacts, children tend to be the most vulnerable population. CASE: We present a case of the borderline lepromatous type of leprosy in a 9-year-old Indonesian male patient with the chief complaint of three stiff fingers on his left hand that began four years ago and hypopigmented patches on the back and buttocks that began five years ago. In this case, there was a history of leprosy in his mother`s sister, who had died. Leprosy in the patient was suspected of possibly being transmitted from his mother`s sister who had intense contact with the patient. The results of bacteriological examination with Ziehl- Neelsen staining of tissue scrapings found acid-fast bacilli. He was treated with a multibacillary multidrug regimen for 12 months. Periodical observations after the patient received the treatment revealed no new spots on the patient`s skin, some of the previous hypopigmented patches seemed to fade, especially those on the back. CONCLUSIONS: In the absence of an effective vaccine, early diagnosis and treatment are critical in preventing disability and deformity and reducing the physical, psychosocial, and economic burden of the disease.
Subject(s)
Leprosy, Borderline , Leprosy, Lepromatous , Leprosy, Multibacillary , Leprosy , Infant, Newborn , Child , Humans , Male , Leprosy, Lepromatous/diagnosis , Leprosy, Lepromatous/drug therapy , Leprosy, Borderline/diagnosis , Leprosy, Borderline/drug therapy , Leprosy/diagnosis , SkinABSTRACT
Objective: The preferred therapy for staghorn stones and large kidney stones is percutaneous nephrolithotomy (PCNL). Ultrasound-guided PCNL has definite advantages over fluoroscopy-guided PCNL. Preoperative characteristics are essential to assess better surgical outcomes. The goal of this study was to analyze the correlation of hydronephrosis with surgical outcomes after ultrasound-guided supine PCNL. Methods: A retrospective study was conducted at Doris Sylvanus General Hospital. Data of the patients was obtained from hospital records. Hundred and five patients underwent ultrasound-guided PCNL in the supine position from August 2020 to August 2022. Data were analyzed using SPSS 16.0. Results: The presence of hydronephrosis was 85 (80.95%), which consisted of Grade I 15 (14.30%), Grade II 25 (23.80%), Grade III 28 (26.70%), and Grade IV 17 (16.20%). In our study analysis, complications occurred in 16 patients (15.23%). Grade I complications of the Clavien-Dindo classification was of in 4 cases, 11 cases of grade 2 complications, and 1 patient died. The statistical result was the relationship between grade hydronephrosis and the grade of complication using the modified Clavien-Dindo system. We found a p-value of 0.207 (>0.05), and there is no statistically significant relationship p=0.382 and r=-0.086 was a negative correlation. There is also no statistically significant relationship between hydronephrosis and stone clearance with p=0.310. Conclusions: The use of ultrasonographic guidance PCNL has been reported as a safe and effective procedure for the management of large renal stones. In this study, there was no correlation or signification between hydronephrosis and surgical outcome after ultrasound-guided supine PCNL.
ABSTRACT
A urinary tract stone is a common urologic problem in Asia. In recent years, the incidence of urinary tract stones has increased but tends to be neglected by people with a lack of knowledge and low socioeconomic status. The occurrence of a bladder stone weighing more than 100 grams is unusual. We report the case of a 46-year-old Indonesian male patient who presented with complaints of lower abdominal pain, urinary pain, frequency, urgency, and hematuria. The patient also had severe anemia due to chronic hematuria. The patient then received open cystolithotomy because the ultrasonographic and X-ray findings of the kidney, ureter, and bladder revealed a giant bladder stone. This bladder stone measured 62 × 59 mm and weighed 301 grams. Gender, age, living in a tropical country, and lack of knowledge contributed to the patient's neglect of symptoms.