Twenty-four-hour urine constituents in stone formers: a study from the northeast part of Peninsular Malaysia.

Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospitals in the same geographical region; 96 patients fulfilled the inclusion criteria and an informed consent was obtained from all subjects. The 24-h urine was collected in sterile bottles with a preservative agent and calcium, oxalate, citrate, uric acid, magnesium and phosphate were tested using commercial kits on a Roche Hitachi 912 chemistry analyzer. The age (mean ± SD) of 96 patients was 56.45 ± 13.43 years and 82.3% of the patients were male while 17.7% were female. The 24-h urine abnormalities were hypercalciuria (14.5%), hyperoxaluria (61.4%), hypocitraturia (57.2%), hyperuricouria (19.7%), hypomagnesuria (59.3%) and hyperphosphaturia (12.5%). Hyperoxaluria (61.4%) was the most common abnormality detected during the analysis of 24-h urine constituents in contradiction to industrial countries, where hypercalciuria was the most common finding. The high frequencies of hypomagnesuria and hypocitraturia reflect the important role of magnesium and citrate in stone formation and their prophylactic role in the treatment of urinary stone disease in the given population.

Pneumatic ureterolithotripsy in paediatric and adolescent patients: a ten-year experience at the Hospital Universiti Sains Malaysia.

INTRODUCTION: Two to three percent of stone disease cases occur in the paediatric age group. It is common in some parts of the world, such as in Turkey, India and Thailand. More than 50 percent of stones in children are still managed through open surgery. Ureteroscopic intervention for children remains a challenging treatment option. However, in contemporary urology practice, this mode of intervention is becoming more common. In this retrospective study, we reviewed our experiences with ureteroscopy and pneumatic lithotripsy in the paediatric and adolescent age group. METHODS: A total of 13 patients at or below the age of 18 years underwent 17 retrograde semirigid ureteroscopy between 1998 and 2008. Their median age was 14 (range 3-18) years. The technique of ureterolithotripsy used for this age group was similar to that used among adults. The ureteric orifice and intramural part of the ureter were not dilated in all the patients. A double J stent was inserted into all the patients. RESULTS: The mean stone size was 7.9 (range 5-13) mm. The stone was in the distal ureter in eight patients, in the mid ureter in seven patients and at the ureterovesical junction in another two patients. The overall stone-free rate after one ureterolithotripsy procedure was 84.6%. We failed to clear the stones in two patients at the first sitting. CONCLUSION: Semi-rigid ureteroscopy and pneumatic ureterolithotripsy are safe and effective procedures that can be performed without ureteric dilation in experienced hands.

Sesquiterpene lactones and other constituents from Hymenoxys richardsonii and H. subintegra.

Two Hymenoxys species afforded, in addition to known compounds, three new pseudoguaianoloides, a new sesquiterpene glucoside and a new butyrolactone. This is the first report of an eudesmane from the genus Hymenoxys. The structures were elucidated by high-field NMR and chemical transformations.

Abietane diterpenes from Lepechinia urbaniana.

Lepechinia urbaniana was investigated with respect to abietane diterpenes. In addition to four widespread diterpenes, two rare compounds were isolated and characterized.