April 25, 2018, 3:13 pm
Facebook iconTwitter iconYouTube iconGoogle+ icon
1 Philippine Peso = 0.07044 UAE Dirham
1 Philippine Peso = 2.01285 Albanian Lek
1 Philippine Peso = 0.03414 Neth Antilles Guilder
1 Philippine Peso = 0.3869 Argentine Peso
1 Philippine Peso = 0.02498 Australian Dollar
1 Philippine Peso = 0.03414 Aruba Florin
1 Philippine Peso = 0.03836 Barbados Dollar
1 Philippine Peso = 1.59992 Bangladesh Taka
1 Philippine Peso = 0.03047 Bulgarian Lev
1 Philippine Peso = 0.00723 Bahraini Dinar
1 Philippine Peso = 33.58228 Burundi Franc
1 Philippine Peso = 0.01918 Bermuda Dollar
1 Philippine Peso = 0.025 Brunei Dollar
1 Philippine Peso = 0.13157 Bolivian Boliviano
1 Philippine Peso = 0.06531 Brazilian Real
1 Philippine Peso = 0.01918 Bahamian Dollar
1 Philippine Peso = 1.26103 Bhutan Ngultrum
1 Philippine Peso = 0.18432 Botswana Pula
1 Philippine Peso = 383.96625 Belarus Ruble
1 Philippine Peso = 0.03832 Belize Dollar
1 Philippine Peso = 0.02447 Canadian Dollar
1 Philippine Peso = 0.01871 Swiss Franc
1 Philippine Peso = 11.4346 Chilean Peso
1 Philippine Peso = 0.12071 Chinese Yuan
1 Philippine Peso = 52.91139 Colombian Peso
1 Philippine Peso = 10.76908 Costa Rica Colon
1 Philippine Peso = 0.01918 Cuban Peso
1 Philippine Peso = 1.72344 Cape Verde Escudo
1 Philippine Peso = 0.3961 Czech Koruna
1 Philippine Peso = 3.39145 Djibouti Franc
1 Philippine Peso = 0.1164 Danish Krone
1 Philippine Peso = 0.94764 Dominican Peso
1 Philippine Peso = 2.1869 Algerian Dinar
1 Philippine Peso = 0.24445 Estonian Kroon
1 Philippine Peso = 0.33832 Egyptian Pound
1 Philippine Peso = 0.52167 Ethiopian Birr
1 Philippine Peso = 0.01562 Euro
1 Philippine Peso = 0.03879 Fiji Dollar
1 Philippine Peso = 0.01369 Falkland Islands Pound
1 Philippine Peso = 0.01368 British Pound
1 Philippine Peso = 0.08493 Ghanaian Cedi
1 Philippine Peso = 0.89893 Gambian Dalasi
1 Philippine Peso = 172.6122 Guinea Franc
1 Philippine Peso = 0.1407 Guatemala Quetzal
1 Philippine Peso = 3.94879 Guyana Dollar
1 Philippine Peso = 0.15041 Hong Kong Dollar
1 Philippine Peso = 0.4519 Honduras Lempira
1 Philippine Peso = 0.11558 Croatian Kuna
1 Philippine Peso = 1.23341 Haiti Gourde
1 Philippine Peso = 4.85501 Hungarian Forint
1 Philippine Peso = 266.4557 Indonesian Rupiah
1 Philippine Peso = 0.06754 Israeli Shekel
1 Philippine Peso = 1.26972 Indian Rupee
1 Philippine Peso = 22.70809 Iraqi Dinar
1 Philippine Peso = 805.52361 Iran Rial
1 Philippine Peso = 1.92079 Iceland Krona
1 Philippine Peso = 2.37438 Jamaican Dollar
1 Philippine Peso = 0.01359 Jordanian Dinar
1 Philippine Peso = 2.06782 Japanese Yen
1 Philippine Peso = 1.91408 Kenyan Shilling
1 Philippine Peso = 1.31497 Kyrgyzstan Som
1 Philippine Peso = 76.83161 Cambodia Riel
1 Philippine Peso = 7.65286 Comoros Franc
1 Philippine Peso = 17.26122 North Korean Won
1 Philippine Peso = 20.47315 Korean Won
1 Philippine Peso = 0.00575 Kuwaiti Dinar
1 Philippine Peso = 0.01573 Cayman Islands Dollar
1 Philippine Peso = 6.25738 Kazakhstan Tenge
1 Philippine Peso = 158.78405 Lao Kip
1 Philippine Peso = 28.8646 Lebanese Pound
1 Philippine Peso = 2.99962 Sri Lanka Rupee
1 Philippine Peso = 2.50441 Liberian Dollar
1 Philippine Peso = 0.23188 Lesotho Loti
1 Philippine Peso = 0.05847 Lithuanian Lita
1 Philippine Peso = 0.0119 Latvian Lat
1 Philippine Peso = 0.02539 Libyan Dinar
1 Philippine Peso = 0.17621 Moroccan Dirham
1 Philippine Peso = 0.31433 Moldovan Leu
1 Philippine Peso = 0.95589 Macedonian Denar
1 Philippine Peso = 25.29728 Myanmar Kyat
1 Philippine Peso = 45.79977 Mongolian Tugrik
1 Philippine Peso = 0.15492 Macau Pataca
1 Philippine Peso = 6.75105 Mauritania Ougulya
1 Philippine Peso = 0.64212 Mauritius Rupee
1 Philippine Peso = 0.29862 Maldives Rufiyaa
1 Philippine Peso = 13.71883 Malawi Kwacha
1 Philippine Peso = 0.35542 Mexican Peso
1 Philippine Peso = 0.07476 Malaysian Ringgit
1 Philippine Peso = 0.23032 Namibian Dollar
1 Philippine Peso = 6.88531 Nigerian Naira
1 Philippine Peso = 0.59455 Nicaragua Cordoba
1 Philippine Peso = 0.15025 Norwegian Krone
1 Philippine Peso = 2.02693 Nepalese Rupee
1 Philippine Peso = 0.02661 New Zealand Dollar
1 Philippine Peso = 0.00738 Omani Rial
1 Philippine Peso = 0.01918 Panama Balboa
1 Philippine Peso = 0.06167 Peruvian Nuevo Sol
1 Philippine Peso = 0.06232 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.21711 Pakistani Rupee
1 Philippine Peso = 0.06525 Polish Zloty
1 Philippine Peso = 105.81128 Paraguayan Guarani
1 Philippine Peso = 0.06981 Qatar Rial
1 Philippine Peso = 0.07297 Romanian New Leu
1 Philippine Peso = 1.17426 Russian Rouble
1 Philippine Peso = 16.19889 Rwanda Franc
1 Philippine Peso = 0.07192 Saudi Arabian Riyal
1 Philippine Peso = 0.14921 Solomon Islands Dollar
1 Philippine Peso = 0.25758 Seychelles Rupee
1 Philippine Peso = 0.34621 Sudanese Pound
1 Philippine Peso = 0.1621 Swedish Krona
1 Philippine Peso = 0.02526 Singapore Dollar
1 Philippine Peso = 0.01369 St Helena Pound
1 Philippine Peso = 0.42589 Slovak Koruna
1 Philippine Peso = 146.33679 Sierra Leone Leone
1 Philippine Peso = 10.79785 Somali Shilling
1 Philippine Peso = 382.92676 Sao Tome Dobra
1 Philippine Peso = 0.16782 El Salvador Colon
1 Philippine Peso = 9.87687 Syrian Pound
1 Philippine Peso = 0.2317 Swaziland Lilageni
1 Philippine Peso = 0.60153 Thai Baht
1 Philippine Peso = 0.04709 Tunisian Dinar
1 Philippine Peso = 0.04287 Tongan paʻanga
1 Philippine Peso = 0.07793 Turkish Lira
1 Philippine Peso = 0.12937 Trinidad Tobago Dollar
1 Philippine Peso = 0.56552 Taiwan Dollar
1 Philippine Peso = 43.65171 Tanzanian Shilling
1 Philippine Peso = 0.50153 Ukraine Hryvnia
1 Philippine Peso = 70.73264 Ugandan Shilling
1 Philippine Peso = 0.01918 United States Dollar
1 Philippine Peso = 0.54066 Uruguayan New Peso
1 Philippine Peso = 154.48792 Uzbekistan Sum
1 Philippine Peso = 1138.30075 Venezuelan Bolivar
1 Philippine Peso = 436.67051 Vietnam Dong
1 Philippine Peso = 2.02071 Vanuatu Vatu
1 Philippine Peso = 0.04846 Samoa Tala
1 Philippine Peso = 10.24242 CFA Franc (BEAC)
1 Philippine Peso = 0.05178 East Caribbean Dollar
1 Philippine Peso = 10.24242 CFA Franc (BCEAO)
1 Philippine Peso = 1.85386 Pacific Franc
1 Philippine Peso = 4.79287 Yemen Riyal
1 Philippine Peso = 0.23169 South African Rand
1 Philippine Peso = 99.53011 Zambian Kwacha
1 Philippine Peso = 6.94093 Zimbabwe dollar

Painful renal calculi

Renal calculi (kidney stones) are chemical crystals that form into a hard salt solid structure that looks like and feels like a common stone we find on the streets. They vary in size, shape, and consistency, according to their chemical composition. They could be calcium oxalate stone, cystine stone, uric acid stone, infection stone, or even a combination.

Where do these stones come from?
Our two bean-shaped kidneys are important blood filters which eliminate chemical waste from our body and excreted into the urine. Without our kidneys, the build up of chemical waste in our body could reach a poisonous, even deadly, level within a few days. In people who have a high risk of forming stones, these chemical crystals solidify in the kidney calices (cup-shaped areas of the kidney). Some of these stones could travel down the ureter (a small muscular tube the connects each kidney to the bladder), causing severe colicky pains from ureteral irritation and spasm.

How large are these stones?
Renal stones vary in sizes, from the size of a grain of sand to as large as a golf ball. Many small stones (silent stones) are passed naturally. Medium stones are often crushed with ESWL (Extracorporeal Shock Wave Lithotripsy), popularly known as Lithotripsy for short. Large stones may need Percutaneous Lithotripsy. Very large stones may need surgical removal, especially the staghorn calculus, which “staghorn” shape and large size lodge it in the kidney pelvis (main chamber) and prevent it from entering and passing down the small ureter. Some stones have round, smooth, surface, and could pass down the ureter to the bladder with lesser pains. Others have sharp, jagged edges, causing more pains when they travel down, or get caught, in the ureter.

What increases the risk for stones?
Not drinking enough fluids, dehydration, eating certain foods, urinary tract infection, living in hot climate, and family history of kidney stones are the more common factors that increase the risk of kidney stone formation. Metabolic or endocrine problems are rarer causes.

How much water should one drink daily?
In a normal average daily situation, it is advisable to drink about 8 glasses of fluids (water, juices, preferably not pop) a day, whether one had kidney stones before or not. Those who had kidney stones in the past are advised against cola drinks, tea, chocolate, spinach, and peanut, which are high in oxalate, and dairy products which are high in calcium. Those with cystine stones are advised against eating foods high in Methionine, like fish.
    
Is renal colic really more painful than childbirth?
Yes, women who had kidney stone colics and had given birth say so. The pain is most excruciating, and in men, it could radiate down to the lower abdomen and to the scrotum of the affected side where the stone is. One thrashes around to find a more comfortable position, only to find none. Narcotic shots are given for the relief of the severe renal colic. Sometimes, renal colic could mimic, or be confused with, acute appendicitis. In some patients, there could be blood in the urine, from the irritation of the ureter where the stone is lodged.

What are the diagnostic tests for kidney stones?
After a thorough history-taking and physical examination, your physician may order  urinalysis, urine culture (for bacteria), blood count, blood chemistry (including calcium, phosphorus, BUN, creatinine, uric acid, and electrolytes) a KUB (plain x-ray of kidney, ureter, bladder), an IVP (intravenous pyelogram, x-ray with dye to see locate the stone), an Ultrasound (a “3-Dimensional” picture of the kidney); and/or a CT Scan (Computed Tomography, an X-ray technique showing cross-sectional images of the abdominal area to locate and identify the stone). Twenty four-hour urine sample may also be taken to find out the levels of stone-related chemicals in the urine. Provocative Tests may also be done to see how the kidneys handle chemicals. Stone analysis is essential to determine the chemical composition of the stone, which will help identify the cause of the stone formation and aid in the preventive treatment in the future.

Are some stones dissolved by medications?
Yes, bicarbonate/potassium citrate may dissolve uric acid stones and cystine stones. This is why it is important strain the urine when one suspects kidney stones, to find out what the chemical composition of the stone is. Medications prescribed to dissolve kidney stones are taken for a lifetime. Unfortunately, not all stones are dissolved by medications. However, many kidney stones are passed naturally. Sometimes alpha blocker drug is used to relax the muscles of the ureter to allow passage of larger stones. Newer extracts to dissolve all types of kidney stones (and gallstones also) are being researched in laboratories around the world.

How does one prevent renal stones?
Uric Acid stones are found among those who overproduce uric acid (gout), and can be worsened by a high-meat diet (high in purines), especially pork and beef. Allupurinol is one drug that reduces uric acid. Cystine stones come from too much cystine (amino acids) in the body, caused by an inherited condition. Penicillamine or Tiopronin reduces cystine. Prevention in this case includes diet low in methionine (a normal chemical found in fish). Infection stones, as the name suggests, is caused by a rinary tract infection. Antibiotics are given before the stones are removed. In all these three conditions, drinking lots of water helps a lot in preventing recurrent kidney stones. Popular old-fashioned lemonade is effective in reducing kidney stone formation.

What is ESWL?
If the stone or stones cannot be dissolved by medications or are too large to pass down the ureter, Extracorporeal Shock Wave Lithotripsy is an option. There are several types of ESWL but the principle is the same for all. The patient lie down or sits up in a water bath, high-energy shock waves from the high-tech machine are precisely aimed at the stone (with pin-point accuracy). The waves, passing through the water cushion, travel at a high speed, pass through the soft tissues of the body without harming them and “shatter” the stone (only) into very fine sand. The procedure is done with mild sedation, and may last about an hour and done as an outpatient or on an overnight stay. 

What is the surgical treatment?
If all of the above therapies fail, invasive or surgical approach is the final option. This includes fishing out the stone in the ureter with a Ureteroscope. Percutaneous Lithotripsy is used for stones larger than one inch in diameter and where ESWL did not work. A small skin incision is made in the affected flank and the stone is shattered by painless ultrasound, or removed by Percutaneous nephrolithotomy. With the available modern technology today, open surgery is now reserved only for those with very large or oddly located kidney stones. 

***

Visit philipSchua.com      
Email: scalpelpen@gmail.com
Rating: 
Average: 5 (1 vote)

Column of the Day

Facebook + Vera Files + Rappler = Truth?

By DAHLI ASPILLERA | April 25,2018
‘Vera Files and Rappler’s claim to glory--their membership in The Poynter, an alcohol industry-funded journalism institute. Some conflict of mores and ethos!’

Opinion of the Day

A lawyer-blogger’s view on the quo warranto petition vs Sereno (2)

By ELLEN TORDESILLAS | April 25, 2018
‘This shortcut will yield greater mischief than the good that irregular removal seeks to achieve.’