Renal stone formation or Urolithiasis Types, composition and clinical features.

 Urolithiasis or Renal stone formation and its types. 

Urolithiasis:

It is formation of stones or calculus  in kidney.

 i.  more common in man than women.

ii. above age of 70 almost 11% of men and 5.6% of women will likely to develop Renal stones.

Types of Renal stones and it composition:

Following are most common  types of kidney stones with their common causes.

1.      1. Calcium stones: about 80% of stones majorly contain calcium, either in form of Calcium Oxalate or mixture of Calcium Oxalate and Calcium Phosphate.

Common causes of Calcium stones:

a.      Most common cause is Idiopathic Hypercalciuria.

b.      Hypercalcemia and Hypercalciuria  

c.       Hyperoxaluria.

d.      Hyperuricosuria.

e.      In some cases (15 to 20%) there is no any known metabolic abnormality.

2.     2. Struvite stones : Almost 10% of stones are composed of Magnesium Ammonium Phosphate, these are commonly  known as Magnesium stones.

Causes of Struvite or Magnesium stones:

a.      Such stones are associated with Urinary track infections, specifically infections of Urea splitting bacteria like Proteus vulgaris and staphylococci. These bacteria either increase the chances of Struvite stone formation (like staphylococci and protease vulgaris etc.) or directly  cause any stone formation. During formation of these stones Patients produce alkaline Urine.

3.      3.Uric acid stone:

         Almost 6 to 7% of stones has Uric acid composition.

Causes of Uric acid stones :

a.      Almost half of cases associated with Hyperuricemia and Hyperuricosuria.

b.      Other half cases are idiopathic. There acid urine are produced, probably this lower pH urine favours uric acid stone formation.

4.      4.Cystine stones: 

       1 to 2 % of stones  has cystinic composition.

Causes of Cystine stone formation:

a.      This is almost always associated with genetic defects in renal transport of amino acids like Cystine. These also form when Urine is acidic.

Clinical features of Renal stones/ Urolithiasis:

a.     a. Clinical significance of Renal stone is associated with their capacity of abstracting urine flow or causing trauma and leading to haematuria or renal bleeding.

b.     b. Stones at their original sites are asymptomatic.

c.      c.  Flank pain (Renal pain) starts when stones dislocate or cause abstraction of urine.

d.    d.   Renal or ureteral colic is condition when renal stones replace inside kidney or to ureter, and initiate flank pain. 

 

Blood smear and its preparation

   What is blood smear?

It is a thin film of blood on slide, that after staining is used to examine mainly the morphology of blood cells.

Why we make and examine blood smears?

We make and examine or investigate smear because  from its examination we can get following useful information:

a.      a. A leukocyte estimate RBC & platelet morphology

b.      b. A 100-cell leukocyte differential Observation for the presence of abnormal Cell.

c.      c. Abnormal RBC distribution, platelet estimate Malarial parasite.

d.    d.  It help us in screening of illness and diagnosis of hematologic & non-hematologic conditions.

e.     e. It also help us to monitor patient response to therapy.

BLOOD SMEAR TYPES

There are two types of smear on base of method of preparation;

1.Spun smear

2.The wedge smear.

There are two additional types of blood smear (On base of their composition) used for specific purposes:

1.Buffy coat smear for WBCs<1.0×109/L

2.Thick blood smears for blood parasites.

1.WEDGE SMEAR :

It is most common, widely used  and preferable method. Lab workers make it by hands, using slides. It is easy to be labelled .

WEDGE SMEAR PREPARATION:

a.     a. A drop of blood is applied on slide, through capillary tube, near an end od slide.

b.     b. Spreader commonly a second slide is draw back toward drop of blood and held there for some time until blood spread to its width.

c.     c. Now the spreader at 45 degree, is pushed forward to produce a long thin and even smear or film of blood.

 CHARACTERISTICS OF A GOOD BLOOD FILM:-

1.Thick at one end, thinning out to a smooth rounded feather edge.

2.Should occupy 2/3 of the total slide area (min. length of 2.5cm)

3.Should not touch any edge of the slide.

4.Should be margin free, except for point of application5.No streaks, waves or troughs

2. SPUN METHOD OF SMEAR FORMATION:

It is an automated method . Here we produce a perfect smear by using a specific machine. Commonly Beckman Coulter Gen.SCell is used.

Preparation of smear through spun method:

a.      a. 1-2 drops of blood placed in are of glass slide.

b.      b.The   briefly spun at high speed in a special centrifuge.

c.       c.Blood spreads on slide in a monolayer Leukocytes & platelets are distributed uniformly & free of distortion. RBC  show tendency to distort •Bio hazardous (aerosols)

 

The Bilderberg

 

Bilderberg Group:

 It is a group of elites or oligarchs from whole world, that controls or rule this world.  This is one of, what people know as Deep state or secret society.

History of Bilderberg:

Its annual meetings were initiated by the Prince Bernhard of Netherland in 1954. First meeting was held in Bilderberg Hotel Holland.

Since that, every years its members attend its annual meetings at different places of world.  

After WWII predicting the fall of their Kingdoms, European Royalties made this deep state, so that they could maintain their power and wealth. They are now working as Oligarchs and control the economy and politics of whole world. At this time their members or not just Europeans rather it has elites from entire world.

Meetings of Bilderberg group:

Meetings take place every year at different places, but these are completely hidden from media, no one is allowed even to be nearer to place where they are meeting. In meetings military heads are also been there.

Aims of Bilderberg group:

The aim is controlling the every the world.

They believe in war economy and earn wealth from that.

They use human rights and Democracy as tools, for achieving their aims.