Urinary stone disease is an ailment that has afflicted human kind for many centuries. Nephrolithiasis is a significant clinical problem in everyday practice with a subsequent burden for the health system. Nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis of stones as well as their prevention and cure still remains rudimentary. Regardless of the fact that supersaturation of stone-forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation. The pathogenesis of calcium oxalate stone formation is a multistep process and essentially includes nucleation, crystal growth, crystal aggregation, and crystal retention. Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person's ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it. Besides low urine volume and low urine pH, high calcium, sodium, oxalate and urate are also known to promote calcium oxalate stone formation. Many inorganic (citrate, magnesium) and organic substances (nephrocalcin, urinary prothrombin fragment-1, osteopontin) are known to inhibit stone formation. This review presents a comprehensive account of the mechanism of renal stone formation and the role of inhibitors/promoters in calcium oxalate crystallisation.

Background: The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet. Methods: A retrospective study covering a period of about 13 years (2005-18) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated. Results: The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts.  However, in all religious groups, 21-40 years old subjects were found to be most susceptible to the problem and approximately 90% of the urinary stones were recovered from the kidneys and primarily composed of calcium oxalate. Conclusion: The co-relationship between the occurrence of urinary stones with age, sex of the patients, their religion & site of stones on diagnosis was found to be statistically significant.  Keywords: Urolithiasis, Urinary Stone disease, Urinary calculus, Renal stones.

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Background: Biochemical markers of acute neuronal injury may aid in the diagnosis and management of cerebrovascular stroke. Neuron specific enolase (NSE) is one such marker which is released in the blood in acute neuronal injury and can be estimated in the serum of patients to assess the short-term neurological outcome. This study was carried out on patients of acute cerebrovascular stroke with the aim to compare NSE levels in normal subjects with that in cerebrovascular stroke patients. Methods: 60 subjects investigated in the study included 30 cerebrovascular stroke patients who were admitted within 72 hours of onset of stroke symptoms, in the Emergency Department and the Department of Neurology at HIMS, and 30 healthy controls. Serum NSE levels of cases and controls were determined on day 1 and day 7 using DRG-NSE ELISA kit. Statistical analysis was performed using the unpaired 't' test on SPSS software for windows version 17.0 Results: There was a significant difference in the levels of serum NSE between cases and controls (p<0.001).The mean levels of serum NSE in controls were 2.25±2.12 ng/ml and in cases at the time of admission were 89.18±46.89 ng/ml . The normal range of serum NSE is 0-12 ng/ml. It was also observed that the levels of serum NSE showed no difference in males or females or among different age groups. Conclusion: This study showed that estimation of serum NSE levels can be used as an early marker of neuronal damage in acute cerebrovascular stroke patients.

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