1. Hematuria is defined as more than 5 red blood cells per high power field in urine. It can be transient and microscopic or gross.
2. Causes of hematuria include glomerular and non-glomerular diseases of the kidneys, as well as conditions of the ureters, bladder, and urethra.
3. Evaluation of hematuria involves microscopic examination to confirm red blood cells and exclude other causes that can cause a positive dipstick. Further tests are aimed at identifying the specific underlying condition and its location.
Approach to Hematuria including:
Definition of Hematuria.
Pathophysiology of Hematuria.
Differential Diagnosis of Red Urine.
Causes of Hematuria.
Approach to a patient with Hematuria.
Diagnostic Algorithms.
Management and Disposition.
HELLO FRIENDS HERE CAUSES OF HEMATURIA IS HERE MANAGEMENT IN NEXT PRESENTATION ...YOU CAN SEE AND SUBSCRIBE OVER YOU TUBE ...LEARN UROLOGY IS CHANNEL NAME
FOLLOW THE YOU TUBE CHANNEL FOR FUTURE UROLOGY VIDEO
https://www.youtube.com/channel/UCINcUe475Y3c3BvXHvZ8wEw
Hematuria for undergraduates
this is a presentation i prepared for medical students about hematuria, hope u like it
for more urology resources visit:
www.uronotes2012.blogspot.com
Approach to Hematuria including:
Definition of Hematuria.
Pathophysiology of Hematuria.
Differential Diagnosis of Red Urine.
Causes of Hematuria.
Approach to a patient with Hematuria.
Diagnostic Algorithms.
Management and Disposition.
HELLO FRIENDS HERE CAUSES OF HEMATURIA IS HERE MANAGEMENT IN NEXT PRESENTATION ...YOU CAN SEE AND SUBSCRIBE OVER YOU TUBE ...LEARN UROLOGY IS CHANNEL NAME
FOLLOW THE YOU TUBE CHANNEL FOR FUTURE UROLOGY VIDEO
https://www.youtube.com/channel/UCINcUe475Y3c3BvXHvZ8wEw
Hematuria for undergraduates
this is a presentation i prepared for medical students about hematuria, hope u like it
for more urology resources visit:
www.uronotes2012.blogspot.com
POSTERIOR URETHRAL VALVES- Pediatric Surgery
• Dear viewers,
• Greetings from “ Surgical Educator”
• Today I have uploaded one more video in Pediatric Surgery/Pediatric Urology- “ Posterior Urethral Valves”
• Posterior Urethral Valves is the congenital cause for Bladder Outlet Obstruction, resulting in abnormal development of the kidneys as well as the bladder.
• In this video, I talked about the learning outcomes, introduction, etiopathogenesis, clinical features, investigations, differential diagnosis, treatment, follow-up and prognosis of “ Posterior Urethral Valves”
• I hope you will enjoy the video for its educational value.
• You can watch all my teaching videos in the following links
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
Evaluation of the patient with hematuria , with recent update in Diagnosis, Evaluation, and Follow-up of asymptomatic microscopic hematuria (AMH) in Adult | american association of urology AUA guideline
POSTERIOR URETHRAL VALVES- Pediatric Surgery
• Dear viewers,
• Greetings from “ Surgical Educator”
• Today I have uploaded one more video in Pediatric Surgery/Pediatric Urology- “ Posterior Urethral Valves”
• Posterior Urethral Valves is the congenital cause for Bladder Outlet Obstruction, resulting in abnormal development of the kidneys as well as the bladder.
• In this video, I talked about the learning outcomes, introduction, etiopathogenesis, clinical features, investigations, differential diagnosis, treatment, follow-up and prognosis of “ Posterior Urethral Valves”
• I hope you will enjoy the video for its educational value.
• You can watch all my teaching videos in the following links
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
Evaluation of the patient with hematuria , with recent update in Diagnosis, Evaluation, and Follow-up of asymptomatic microscopic hematuria (AMH) in Adult | american association of urology AUA guideline
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
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Haematuria prof mohamed sobh
1. Urology & Nephrology Center, Mansoura University,
HAEMATURIA
By
Mohamad A. Sobh, MD, FACP
Prof. of Nephrology
Urology & Nephrology Center
Mansoura University
Egypt
2. Urology & Nephrology Center, Mansoura University,
Definitions:
Normally the number of RBCs in urine
should not be more than 5 RBCs/ high
power field on microscopic examination
of fresh centrifuged urine sample.
So, haematuria is defined as a secretion of
more than 5 RBCs/ HPF in urine.
Haematuria
3. Urology & Nephrology Center, Mansoura University,
Transient microscopic haematuria is
relatively common. Up to 40% of adults
between ages of 18 and 33 may have
microscopic haematuria at least once, and
up to 16% may have it in two or more
occasions.
Therefore, an extensive workup is not
indicated except in high-risk patients, > 50
years of age and those patients with other
clinical or urinary abnormalities.
4. Urology & Nephrology Center, Mansoura University,
Initial is usually urethral.
Terminal hematuria is usually prostatic or
bladder origen.
Total hematuria is either bladder, ureteral
or renal origen.
Gross or Microscopic.
Painfull or painless.
Symptomatic or Asymptomatic.
Patterns Of Haematuria
6. Urology & Nephrology Center, Mansoura University,
In gross hematuria, urine looks red if alkaline,
but brown or coca-cola like if urine is acidic
due to denaturation of the hemoglobin.
7. Urology & Nephrology Center, Mansoura University,
False positive test for haematuria:
Haemoglobinuria.
Myoglobinuria.
Ascorbic acid.
False negative test for hematuria:
Highly diluted urine.
8. Urology & Nephrology Center, Mansoura University,
Differential Diagnosis of Haematuria:
A- First, haematuria should be differentiated from
other causes of red or brownish urine:
Haemoglobinuria (haemolysis)
Myoglobinuria (muscle damage)
Porphyrins (in porphyria)
Bile (in jaundice)
Melanin (in melanoma)
Alkaptonuria,
Food dyes.
Drugs as PAS or phenylphthalein.
9. Urology & Nephrology Center, Mansoura University,
Dipsticks (Hemastix) will be positive
with haematuria, haemoglobinuria and
with myoglobinuria but negative with
other causes e.g. porphyrins bile
melanin, alkaptonuria, food dyes and
drugs as PAS or phenylphthalein.
Microscopy will show RBC’s only
with haematuria.
10. Urology & Nephrology Center, Mansoura University,
B-Haematuria could be glomerular (because of
glomerular disease, sometimes called medical); or
non glomerular (sometimes called surgical).
Glomerular haematuria could be differentiated
from non glomerular haematuria by:
1. The shape of RBCs in urine are small and
dysmorphic in cases with glomerular haematuria
while it will be normal in case of non glomerular
haematuria.
11. Urology & Nephrology Center, Mansoura University,
2. Proteinuria is present in most cases of
glomerular hematuria but not in cases of non
glomerular hematuria.
3. Casts, especially red cell casts are seen in
glomerular haematuria.
4. Blood clots indicate non-glomerular bleeding
and can be associated with pain & colic.
12. Urology & Nephrology Center, Mansoura University,
(in dipsticks test reaction occurs between orthotolidine and
haemoglobin or myoglobin).
14. Urology & Nephrology Center, Mansoura University,
Causes of Haematuria
I. Haematuria of renal origin:
Glomerular haematuria
Renal infection and tubulointerstitial diseases.
Renal neoplastic diseases:
Hereditary renal diseases
Coagulation defect
Stone disease.
Renal vascular disease
Exertional haematuria.
II. Haematuria of ureteral origin:
III. Haematuria of bladder origin:
IV. Haematuria of urethral origin.
15. Urology & Nephrology Center, Mansoura University,
Haematuria of renal origin:
a.Glomerular haematuria: Either primary
glomerular disease (e.g. IgA nephropathy,
mesangial proliferative
glomerulonephritis or crescentic
glomerulonephritis); or secondary
glomerulonephritis i.e. renal
involvement is a part of systemic
disease (e.g.post-strephococcal
glomerulonephritis, Henoch-Schönlein
purpura, SLE, polyarteritis nodosa).
20. Urology & Nephrology Center, Mansoura University,
b.Renal infection and tubulointerstitial
diseases: Pyelonephritis, renal papillary
necrosis, tuberculosis, and toxic
nephropathies.
c.Stone disease.
d.Renal neoplastic diseases: Renal cell
carcinoma, transitional cell carcinoma of
the renal pelvis and others.
e.Hereditary renal diseases: Medularly,
sponge kidney, polycystic kidney disease,
Alport’s syndrome, and thin basement
membrane disease.
21. Urology & Nephrology Center, Mansoura University,
f. Coagulation defect: use of
anticoagulant, liver disease and
thrombocytopaenia.
g. Renal vascular disease: Renal
infarction, renal vein thrombosis or
malignant hypertension.
h. Exertional haematuria.
27. Urology & Nephrology Center, Mansoura University,
II. Haematuria of ureteral origin:
a. Malignancy.
b. Nephrolithiasis.
c. Ureteral inflammatory condition
secondary to nearby inflammation
e.g. diverticulitis, appendicitis or
salpingitis.
d. Ureteral trauma e.g. during
ureteroscopy.
e. Ureteral varices, aneurysms, or
arteriovenous malformation.
28. Urology & Nephrology Center, Mansoura University,
III. Haematuria of bladder origin:
a. Infection: schistosoma, viral or bacterial
cystitis.
b. Neoplasma.
c. Foreign body in the bladder e.g.
stones.
d. Trauma: During instrumentation or
accidental.
e. Drug: e.g. cyclophosphamide induced
haemorrhagic cystitis.
29. Urology & Nephrology Center, Mansoura University,
Cyclical haematuria in ♀ suggests
endometriosis of the urinary tract
30. Urology & Nephrology Center, Mansoura University,
IV. Hematuria of urethral (or
associated structures) origen:
a. Urethritis, foreign body or
local trauma to the urethra.
b. Prostate: Acute prostatitis,
benign prostatic hypertrophy.
31. Urology & Nephrology Center, Mansoura University,
1. First exclude haemoglobinuria and
myoglobinuria since both of them can
also cause positive dipstick test for
haematuria. This is done by microscopic
examination of fresh urine sample. In case
of haematuria, RBCs could be seen while
in the other two conditions no RBC’s could
be seen.
Investigations of a case of
haematuria
32. Urology & Nephrology Center, Mansoura University,
In case of myoglobinuria, clinical
examination may show manifestations of
muscle disease and the examination of
urine by immunoelectrophoresis may show
myoglobin.
In case of haemoglobinuria, manifestations
of haemolysis may be evident
33. Urology & Nephrology Center, Mansoura University,
2. Examination of urine for:
Proteinuria.
Casts.
Pus.
Bacteria (specific and non specific)
Culture (Ordinary and special)
PCR (TB-DNA)
34. Urology & Nephrology Center, Mansoura University,
3. Ultasound, plain X-ray, I.V.P. (if
serum creatinine is normal), and
possibly angiography, for the
diagnosis of surgical diseases e.g.
stone, malignancy, infection, or
malformations.
35. Urology & Nephrology Center, Mansoura University,
4. RBCs in urine could be examined for its
shape to differentiate glomerular (small,
distorted) from non glomerular causes
(by phase contrast microscopy).
5. Kidney function tests.
6. Specific investigations for diagnosis of
systemic disease causing haematuria
e.g. SLE.
7. Kidney biopsy for glomerular
haematuria.
36. Urology & Nephrology Center, Mansoura University,
Microscopic haematuria and the risk of ESRD
• A recent longitudinal study of 1.2 million young individuals
(aged 16 – 25) presenting for military service found an initial 0.3%
prevalence of persistent microscopic haematuria (with normal SCr and
proteinuria <200mg/day).
• Males were affected twice as commonly as females.
• During 21 years ’ follow-up, ESRD developed in 0.7% of those with (and
0.045% of those without) initial microscopic haematuria.
• This gave an adjusted hazard ratio of 18.5.
• The mean age of ESRD treatment was earlier (34 vs 38) in the haematuria
cohort and attributed mainly to glomerular disease.
• While the relevant advisory bodies do not presently advocate population
screening, these recent data have led to a call for selected screening of
younger patients so that they can be followed up more closely for the
development of overt renal disease.
* Vivante A, Afek A, Frenkel-Nir Y, et al . (2011). Persistent asymptomatic
isolated microscopic hematuria in adolescents and young adults and risk for
end-stage renal disease. JAMA .
37. Urology & Nephrology Center, Mansoura University,
1. Treatment of the cause.
2. Haemostatic e.g.:
Cyclokapron.
Vitamin K
DDAVP
Frish frozen plasma.
3. Haematenics and blood transfusion.
Treatment Of Haematuria