OBJECTIVE: To determine the potassium and citrate content of the local citrus fruits: calamansi, dalandan and pomelo in comparison with potassium citrate tablets (Acalka*).

MATERIALS AND METHODS: One kg by weight of each fruit was sent to the University of Santo Tomas Herbarium for authentication. Samples were sent to the Industrial Technology Development Institute of D.O.S.T. for quantitative studies of potassium using atomic absorption spectrophotometry and citrate using high performance liquid chromatography.

RESULTS: Citric acid content percent weight by weight: calamansi 5.97; dalandan 1.63; pomelo 0.41. Potassium (K) content in mg/kg: calamansi 178; dalandan 509; pomelo 296. Each 1080 mg of Acalka* contains 390 mg of potassium and 690 mg of citrate.

CONCLUSION: The potassium and citrate content of potassium citrate tablets (Acalka*) are superior in comparison with the fruits analyzed. Fruits cannot be used as monotherapy but can be used as adjuncts with commercially prepared potassium citrate tablets in the medical management of stones.

Potassium Citrate ; Citrus Microcarpa Bunge ; Citrus Auratium ; Citrus Grandis Osbeck ; Urinary Stone

Children born with very rare complex of congenital developmental abnormalities such as aniridia, genito-urinary malformations and mental retardation have higher than 30 percent chance of having a concomitant Wilms' tumor (WAGR Syndrome). This is listed as a rare disease by the Office of Rare Diseases of the National Institutes of Health (NIH).

We report the case of a 20 month old baby diagnosed with WAGR Syndrome who underwent exploratory laparotomy, ipsilateral radical nephrectomy and contralateral partial nephrectomy and contralateral partial nephrectomy. A horseshoe kidney was incidentally diagnosed intra- operatively which is not an uncommon finding as reported by the National Wilms' Tumor Study Group (NWTSG).

This paper aimed to document and reported this rare condition which was completely worked up and address surgically by the subspecialties of pediatric surgery together with the pediatric urology.  

 

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OBJECTIVE: To present the modifications in radical retropubic prostatectomy that would minimize intraoperative blood loss.

METHODOLOGY: Forty-seven patients, 49 to 80 years old underwent radical retropubic prostatectomy for Stage I to II (T1-2NOMO) prostate gland adenocarcinoma from June 1997 to September 2005. Modifications to control the deep dorsal venous complex without occlusion of hypogastric artery was adopted.

RESULTS: The volume of the prostate gland removed ranged from 9.23 to 74 (mean: 36.17 grams). The estimated blood loss ranged from 250 ml to 2,500 ml (mean: 860.64 ml). The operative time was 3 to 5 hours (mean: 3 2/3 hours). Three units of blood were transfused to 3 patients, 2 units to 4 patients, 1 unit to 5 patients and 36 patients had no blood transfusion (mean: 234 ml). Hospital stay ranged from 4 to 10 days (mean: 5.2 days).

CONCLUSION: There was acceptable blood loss comparable with foreign literature with the technical modification adopted in this study.

Prostatectomy ; Retrospective Studies

OBJECTIVES: This paper aimed to describe the complication rates of patients who underwent hypospadia repair according to age, type of hypospadia and stage of repair. It likewise aimed to determine the association of age, type and stage of repair on the occurrence of complications.

METHODS: The study utilized a retrospective cohort design. The study population included pediatric patients who underwent repair of hypospadia at 6 tertiary hospitals (University of Santo Tomas Hospital, Chinese General Hospital, Philippine Children's Medical Center, Hospital of Infant Jesus, Cardinal Santos Medical Center and St. Luke's Medical Center) done by a single surgeon from March 1999 to July 2004. Subjects were classified into three groups by age: Group A (< 2 years), Group B (2-5 years) and Group C (> 5 years). The age, type of repair, stage of repair, and occurrence of complications were obtained from patient's records and were processed using Epi Info v.6. Proportions of subjects in terms of age, type of hypospadia and stage of repair were tabulated. Univariate analysis using Maentel-Haenzel chi-square test was used to determine significant associations between age, type of hypospadia and stage of repair versus occurrence of complications. Significance level was set at a = 0.05. Relative risks or risks ratios (RR) were derived, with their corresponding 95 percent confidence intervals.

RESULTS: A total of 286 subjects who underwent repair of hypospadia in 6 tertiary hospitals from March 1999 to July 2004 were included in the study. Thirty eight percent (38.5 percent) of subjects were below 2 years old and 39.2 percent were subjects more than five years old, while 22.4 percent were between 2 to 5 years old. For the type of hypospadia, the most common was proximal (47.9 percent). Most of the subjects (92.7 percent) underwent first stage repair. The overall complication rate was 15 percent (n=43). The highest complication rate was observed in patients > 5 years old (20.5 percent). Subjects with mid-penile hypospadias had the highest complication rate (25.37 percent). Cross-tabulations showed that subjects more than 5 years old had higher rate of complications (p=0.046). Among patients who underwent first stage repair, the mid-penile type had the highest rate of complications (25.76 percent) (p=0.0004). Most of the subjects who underwent second stage repair were of the proximal type (71.42 percent). Univariate analysis showed that it was only in proximal hypospadias that subjects more than five years old had significantly higher rate of complications (RR=3.21, 95 percent CI=1.09-9.42).

Hypospadias ; Urogenital Abnormalities

The objective of this paper was to describe the bladder and sphincter urodynamic profiles and the upper tract status of patients with myelomeningocoele. This was correlated with the patients age when initially evaluated. Patients from the Spina Bifida Support Group of the Philippines who underwent initial videourodynamics when first seen were included in the study. The procedure was performed using a Laborie Avanti 4.1 model urodynamic machine. The hostile profile included bladder-sphincter dyssynergia, dyssynergic bladder neck/sphincter or leak point pressure greater than 35 cm H2O. The non-hostile picture included areflexic bladder and sphincter, open or areflexic sphincter or leak point pressure less than 35 cm H2O. The upper tracts were also assessed for the presence of hydronephrosis or vesicoureteral reflux There were 83 myelomeningocoele patients who underwent screening videourodynamics. Their ages ranged from 2 months to 19 years. Fifty one patients presented with hostile bladder sphincter profile while 32 patients presented with non-hostile features. Among the patients with hostile features, 37 manifested with hydronephrosis and/or vesicoureteral reflux. Three patients already presented with renal failure. Beyond 2 years old, 34 patients showed hostile bladder sphincter profile. Sixteen patients already presented with hydronephrosis and/or reflux after the age of 5 years. Renal failure was manifested by older children, all exhibited hostile bladder sphincter features and upper tract deterioration. These data showed a positive correlation of age, hostile profile and upper tract changes in patients with myelomengocoele

Human ; Male ; Female ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Urodynamics ; Vesico-ureteral Reflux ; Meningomyelocele ; Spinal Dysraphism ; Hydronephrosis ; Urinary Bladder Diseases ; Renal Insufficiency ; Self-help Groups ; Ataxia