Lithotripters, Stones and Lithotripsy

Stones in kidneys, urinary tract, urinary bladder and gall bladder could be treated with open surgery, percutaneous laproscopic surgery or lithotripsy. Treatment of stones in organs with drugs is of limited scope. A lithotripter is an instrument which breaks up stones in situ by shockwaves, which are focused on them. There are a variety of lithotripters available worldwide. Kidney stones or renal calculi are effectively treated with extracorporeal shockwave lithotripsy (ESWL), though sometimes percutaneous nephrolithotomy (PCNL) or open surgery is also required to remove renal stones. The lithotripsy treatment is said to be successful if stones are eliminated or reduced to <2 mm size. Comparative total cost of treatment by lithotripsy is almost half than by open surgery. ESWL has its own advantages as there is no blood loss and very little morbidity. Extracorporeal shockwave lithotripsy (ESWL) is the cheapest and quickest way of returning patient to normal life.

Extracorporeal shockwave lithotripsy is the best option as a mono-therapy for a medium-size stone (1-2 cm). However, for larger and stag-horn type stones, the best results could only be achieved by multi model approach. After nephrolithotripsy, the fragments of stones are expected to be passed in the urine within about 3 months time. The success rate varies with the size of stones but is always above 80% with ESWL and >90% for percutaneous nephrolithotomy (PCNL). Depending on the location, volume and composition, ureteral and kidney stones need endoscopic treatment via uretero-renoscopy (URS) and/or percutaneous nephrolithotomy.

Childcare and Hospitals for Children

Children constitute around 40% of the world population. Pediatric medicine is a broad specialty embodying all the organ specialties of adult medicine such as cardiology, dermatology, endocrinology, gastroenterology, hepatology, neurology, pulmonology, rheumatology etc. Pediatric surgery and its specialties also make a list as long as in the case of adults' specialties. All hospitals worldwide do have pediatric departments but special hospitals for sick children could provide better care of children by child specialists or pediatricians. The childcare begins at birth with mandatory vaccination planning which could be handled well by specialized vaccinologists. Vaccination and preventive medicine should be allocated special funds, as that would be an investment for the children's welfare and community health. All the countries and states on this earth should have special hospitals for children since childcare is the foundation of a healthy nation.