Global Journal of Urology and Nephrology

Review Article of Global Journal of Urology and Nephrology Alternative Management of Uncomplicated UTIs in Women Abdul Kader Mohiuddin Department of Pharmacy, World University of Bangladesh, 151/8, Green Road, Dhanmondi, Dhaka – 1205, Bangladesh UTIs typically cause women to have a severe urge to urinate, and to do so frequently. It’s also often very painful when they do, and many experiences a burning sensation in their bladder or urethra. Two common factors emerged in urine that had a better ability to resist bacterial growth: it had a high pH—one that’s more alkaline, in other words—and higher levels of certain metabolites formed by gut microbes. Physicians already know how to raise urinary pH with things like calcium supplements, and alkalizing agents are already used in the U.K. as over-the-counter UTI treatments. However, early on in an infection, cells produce a protein called siderocalin that blocks bacterial growth, including the growth of E. coli. Uncomplicated UTIs usually go away with drugs within two to three weeks, but in some cases, women may take antibiotics for 6 months or longer if their UTIs keep coming back. Most UTIs are caused by the bacteria Escherichia coli (E. coli), and recent surveillance data shows a significant rise in cases of UTIs caused by E. coli that are resistant to the antibiotics most commonly used to that treat them. Doctors say “It’s uncomfortable but not life-threatening, so women don’t go in”. Keywords: Escherichia coli, cystitis, recurrent UTIs; bacterial biofilm; fluid consumption; essential oil ...

Case Report of Global Journal of Urology and Nephrology Turning complexity into clarity: polyuria and hypernatremia Awad Magbri, MD, FACP, Shaukat Rashid, MD Surgery and Vascular Center at Regency Park, LLC, Toledo, OH Case history The patient is 65-year old African American male with history of hypertension. He was admitted to hospital with lethargy, disorientation, and confusion. His clinical evaluation and CT of the head revealed subarachnoid hemorrhage. He had h/o stroke 5 years ago. The patient didn’t have fever, but did have a diarrhea of 1-day duration. He is receiving parenteral feeding and his urine output is 4L/day. His physical examination revealed blood pressure of 100/70mmHg, with heart rate of 100 BPM. He has dry mucous membranes and the rest of examination was unremarkable. His laboratory investigation showed sodium 159meg/L, K+ 4.6meg/L, chloride 114mEq/L, HCO3 26mEq/L, creatinine 1.9mg/L, Blood urea nitrogen 64mg/L, and glucose 200mg/L His urine sodium 70mEq/L, and urine osmolality 380mOsm/Kg H2O. His volume status is slightly dry, and he weighs 70Kg. Case discussion This case illustrated several information including polyuria with parenteral nutrition, low blood pressure and dry mucous membranes denoting low extracellular fluids volume. High serum sodium, and high urine osmolality in the face of hypovolemia and hypernatremia. As a consequence of his illness he suffered from low perfusion to the kidneys with worsening kidney function. Hypernatremia is a common electrolyte abnormality and defined as a serum sodium >145mEq/L (1,2,3). Hypernatremia is hyperosmolar state caused by a decrease in total body water (TBW), relative to electrolytes content (4). Therefore, hypernatremia is a water problem not sodium problem. It often occurs in elderly and hospitalized patients with restricted access to water and in those with impaired thirst mechanism (hypodipsia/adepsia) or mental status changes. Developing hypernatremia is virtually impossible if the thirst mechanism is intact and water ...

Case Report of Global Journal of Urology and Nephrology Two Options the sweetest among them is bitter: Fournier-gangrene associated with sodium-glucose co-transporter 2-inhibitors Awad Magbri, MD, FACP, Mariam El-Magbri, BSC, MPH, Kamran Suljuki, PharmD, MBA, Shaukat Rashid, MD. Regency Vascular Access, Toledo, OH The authors discuss a case of sodium-glucose co-transporter 2 inhibitor associated with Fournier-gangrene in a patient with type-2 diabetes millets. The patient had extensive surgical intervention and skin graft but succumbed to her disease. Keywords: Fournier’s gangrene, diabetes, perineum infection, sodium-glucose cotransporter-2 inhibitors, glycosuria ...

Case Report of Global Journal of Urology and Nephrology Large urinary bladder leiomyoma causing right hydronephrosis, a rare case report: diagnosis and management Manjeet Kumar1, Kailash barwal1, Girish Kumar1, Kalpesh Mahesh Parmar2, Pamposh raina1 1 Department of Urology, IGMC, Shimla, Himachal Pradesh, India 2 Department of Urology, PGIMER, Chandigarh, India Background Leiomyoma of the urinary bladder is a rare tumor despite the routine use of ultrasonography. These tumors are typically asymptomatic, sometimes present with hematuria, dysuria, and bladder outlet obstruction. Leiomyoma is a benign tumor which is detected incidentally and rarely causes upper urinary tract changes. (1, 2) We present an extremely rare case of leiomyoma in urinary bladder causing right hydronephrosis and presenting with flank pain. Case summary A 42 years female presented with flank pain in the emergency room as result of hydronephrosis in the right kidney. Imaging of urinary tract revealed 6 x 6.5 cm, a well-circumscribed tumor with right hydroureteronephrosis suggestive of leiomyoma of the urinary bladder. Excision of leiomyoma was done intravesically with preservation of bilateral ureteral orifices’. Conclusion Our case highlights despite being a large tumor there was no ureteral involvement. The hydronephrosis was the result of compression from large sized leiomyoma which was successfully managed by excision of leiomyoma. Keywords: Leiomyoma, urinary bladder, Hydronephrosis, Transurethral biopsy, ureteric orifice ...