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Sonographic Assessment of Urolithiasis in University of Abuja Teaching Hospital, Nigeria

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Sonographic Assessment of Urolithiasis in University of Abuja Teaching Hospital, Nigeria.

ABSTRACT

The prevalence of urolithiasis varies according to geographic areas. Urolithiasis  is  the third most common urological disease with many complications including renal failure. The prevalence is on the rise in Nigeria due to several epidemiological factors including high environmental temperature.

There is paucity of documented scientific study on the prevalence of urolithiasis in the University of Abuja Teaching  Hospital  within  the Federal Capital Territory, Nigeria. This study was conducted to assess the  prevalence  of  urolithiasis  in University of Abuja Teaching Hospital.

The study adopted a cross- sectional survey. This study was conducted at the Department of Radiology, University of Abuja Teaching Hospital within  the  Federal  Capital  Territory (FCT) between June 2014 and May 2015.

A total of 2,310 patients  that underwent abdominopelvic ultrasound in the department and met the inclusion criteria participated in the study. Their age range was between 2 – 64 years. They were recruited using a convenience (non – probability) sampling technique.

Patients identified with urolithiasis were analyzed for age, site, associated clinical symptoms. Data obtained was subjected to descriptive statistics and analyzed using student t–test (paired t -test).  Probably value less than 0.05 was considered statistically significant.

A total of 2,310 patients were scanned, 31 patients were sonographically identified with urolithiasis. The prevalence of urolithiasis was 13.4 per 1000.  The  mean  age  was  31.12± 3.69 years and ranged (2 – 64 years). There were 58.06% males and 41.93% females giving a male to female ratio of 1.3:1. The peak age of incidence was 21 – 50 years.

TABLE OF CONTENTS

Title Page – – – – – – – – – -i
Certification page – – – – – – – – -ii
Dedication – – – – – – – – – -iii
Acknowledgment – – – – – – – – -iv
Table of Content – – – – – – – – -v
List of Tables – – – – – – – – -viii
List of Figures – – – – – – – – -ix
List of Abbreviations – – – – – – – -x
List of Appendices – – – – – – – – -xi
Abstract – – – – – – – – – -xi

CHAPTER ONE: INTRODUCTION

1.1 Background to the Study – – – – – – -1
1.2 Statement of the Problem – – – – – – -5
1.3 Objectives of the study – – – – – – -6
1.3.1 General Objectives – – – – – – – -6
1.3.2 Specific Objectives – – – – – – – -6
1.4 Significant of the Study – – – – – – -6
1.5 Scope of Study – – – – – – – -7
1.6 Operational Definition of Terms – – – – – -7

CHAPTER TWO: LITERATURE REVIEW

2.1 Theoretical background to the study – – – – -9
2.1.1 Pathophysiology of Urolithiasis – – – – – -9
2.1.2 Types of Urolithiasis – – – – – – -10
2.1.3 Clinical Symptoms of Urolithiasis – – – – – -10
2.1.4 Confirmation/Diagnosis of Urolithiasis – – – – -11
2.1.5 Complication of Urolithiasis – – – – – -14
2.1.6 Characteristic appearance of Urolithiasis – – – – -15
2.2 Gross Anatomy of the Urinary Tract – – – – -16
2.2.1 Embryonic Development of the Kidneys – – – – -18
2.2.2 Gross Anatomy of the Kidney – – – – – -19
2.2.3 Ureters – – – – – – – – -21
2.2.4 Urinary Bladder – – – – – – – -22
2.3 Empirical Literature Review- – – – – – -23

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design – – – – – – – -30
3.2 Study Duration- – – – – – – – -30
3.3 Study Location – – – – – – – -30
3.4 Research Population- – – – – – – -30
3.5 Sample Technique – – – – – – – 31
3.6 Sample Size – – – – – – – – -31
3.7 Inclusion Criteria – – – – – – – -31
3.8 Exclusion Criteria – – – – – – – -32
3.9 Equipment/ Procedure – – – – – – -32
3.10 Sonographic Scanning Techniques – – – – – -34
3.11 Sonographic Appearances of Urolithiasis – – – – -35
3.12 Ethical Clearance / Informed Consent – – – – -39
3.13 Method / Instrument of Data Collection – – – – -39
3.14 Data Analysis – – – – – – – – -39

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS.

4.1 Results- – – – – – – – – -40
4.2 Discussion – – – – – – – – -45

CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

5.1 Summary – – – – – – – – -48
5.2 Conclusions – – – – – – – – -48
5.3 Recommendations – – – – – – – – -49
5.4 Limitation of the Study – – – – – – -49
5.5 Areas for Further Research – – – – – – -50
References – – – – – – – – -51
Appendices – – – – – – – – -55

INTRODUCTION

Urolithiasis is the development of calculi anywhere in the urinary system which may result in many complications including renal failure  (Tempkins,  1999). Renal calculi can cause obstruction and urinary stasis that ultimately leads to infection and possible destruction of renal parenchyma.

They may be solitary or multiple and can vary in size from small stones to large  staghorn calculous that  fills the collecting system. Stones usually originate from the kidneys but may pass into the ureter and bladder (Krebs, 1993). A clearly defined  cause of urolithiasis has not been established.

What is known is that their development requires the presence of a nidus and an environment that supports the continuous precipitation of stone components (Porth, 1988). The saturation theory as presented by Kawamura (1999:373) attributes causes to the urine saturated with calcium, uric acid, salts, magnesium phosphates and cystine.

Marak (2013) also stated that urinary calculi form when a crystallizable substance like calcium, oxalate, phosphates, uric acid and cystine exceeds its solubility in urine. According to Olapade (2004), several epidemiological factors can predispose persons to urinary stone formation such as age, sex, race, infection, nutritional status and diet.

Reduced water intake, high concentration of stone constituents, changes in urine PH and high environmental temperatures also tend to predispose  to production of low-volume super-saturated uric acid and the attendant increased risk of stone formation.

REFERENCES

Abubakar A.M, Mungadi I. A, Chinda J.Y, NTI I.O, ..Paediatric Urolithiasis in Northern Nigeria. African Journal of Paediatric Surgery 2004; 1:2 – 5.

Adams Stephen . High dose Vitamin C doubles Kidney Stone Risk. Traditional African Clinic Journal.2013;1-2.

Agbo Paul.(n.d) Heat Waves:Infants worst hit as power drops.( Online).Available  at nnu.com.ng/heat wave.infants.aged

Agburu J. I (2007) Modern Research Methodology .2nd Edition. Kujoma Publishers Ltd. 4:38.

Aji SA Ahassan Su, Mohammed Am, Mashi SA. Urinary stone disease in Kano North western Nigeria. Nigerian Medical Journal 2011; 52:83-85 (Serial online retrieved)Available at. http:IIwww.nigeriamedj.com/article.

Brown J. Diagnostic and treatment patterns for renal colic in US Emergency Departments. International Journal of Uro-Nephrology. 2006; 38:87-92.

Buchholz NP, Abbas F, Afzal M, Khan R, Talati J. The prevalence of  silent Kidney stones. An Ultrasonography screening study. Journal of Pakistan Medical Association 2003: 53: 24-25

CSN Team.

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