Kidney stones can cause the excruciating pain known as renal colic, felt on one’s lower back or sides mostly as a result of a blockage in the urinary tract. The urinary tract includes kidneys, ureters, bladder, and urethra. Ureters carry urine from the kidneys to the bladder while the urethra carries urine to the outside when one urinates.
The pain of renal colic develops suddenly and it comes and goes in a squeeze-release kind of pattern. Renal colic is often described by patients as “the worst pain they have ever felt”. Approximately 10% of people will be affected by renal colic at some point in their lifetime.
What are kidney stones?
‘Kidney stones’ are crystals that form from chemicals in the urine. Kidney stones usually develop because too much of a single chemical is present in the urine. Most of them have been found to be made up of calcium (80%). Urate is also contained in some kidney stones that are more prevalent in obese patients. Despite the severe pain that the kidney stones can cause (when they block the urinary tubes), the majority of them move freely along the tract and pass spontaneously when urinating. Many patients with renal colic can be managed conservatively by a general practitioner with a watchful waiting approach while controlling the pain with pain medications.
Symptoms of kidney stones
Patients with kidney stones classically present with the following; Sudden and severe back or loin pain that occurs in waves of intensity Patients with renal colic typically appear restless and unable to find a comfortable position Nausea and vomiting Some patients may experience urinary symptoms like straining when urinating, painful and frequent urination, visible blood in the urine or very dark coloured urine and small volumes of urine Asymptomatic – Some patients may be symptom-free from the kidney stones especially very small ones (some people are walking around without knowing they have kidney stones until they are found incidentally on imaging) The above combination may help distinguish kidney stone pain from other conditions causing abdominal or back pain.
Which patients are most likely to develop urinary stones?
It is estimated that about 10% of people will experience an episode of renal colic at some stage in their life, with more prevalence in males. Peak ages are between age 40 and 60 years for males and late 20’s for females. Kidney stones are more likely to occur in patients who have the following conditions;
Chronic dehydration resulting in concentrated urine production (e.g. less than one litre of urine production per day) A family history of urinary stones ( 2.5 x increase) An abnormality of the urinary tract Obesity Hyperparathyroidism Gout Idiopathic hypercalciuria Exposure to a hot environment (e.g. outdoor workers ïƒ loss of body fluids ïƒ dehydration)
Diagnosing kidney stones
Upon the patient presenting with a history suggestive of kidney stone pain, the doctor will do full examination which entail pressing or balloting the abdomen and the back. A few tests will be ordered to confirm the kidney stones diagnosis and rule out other causes of renal pain like infections which include; Urinalysis/ urine dipstick (to check for any blood or hematuria) Urine culture Kidney function tests Full blood count Serum urate, calcium and phosphate Ultrasound X-ray of renal tract CT scan (urogram) if available Approximately 90% of patients with urinary stones will return a positive test for haematuria (blood in the urine) on urine dipstick; therefore a negative result is a reason to reconsider the diagnosis.
How to treat kidney stones?
In a patient suspected of having renal colic initial management include; Aggressive on-going pain management with a non-steroidal anti-inflammatory drug like diclofenac Alpha-blocker drugs to accelerate passage of the stone Surgical removal of the stone if conservative management fails
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Seventy-seven years ago, on the evening of December 2, 1943, the Germans launched a surprise air raid on allied shipping in the Italian port of Bari, which was then the key supply centre for the British 8th army’s advance in Italy.
The attack was spearheaded by 105 Junkers JU88 bombers under the overall command of the infamous Air Marshal Wolfram von Richthofen (who had initially achieved international notoriety during the Spanish Civil War for his aerial bombardment of Guernica). In a little over an hour the German aircraft succeeded in sinking 28 transport and cargo ships, while further inflicting massive damage to the harbour’s facilities, resulting in the port being effectively put out of action for two months.
Over two thousand ground personnel were killed during the raid, with the release of a secret supply of mustard gas aboard one of the destroyed ships contributing to the death toll, as well as subsequent military and civilian casualties. The extent of the later is a controversy due to the fact that the American and British governments subsequently covered up the presence of the gas for decades.
At least five Batswana were killed and seven critically wounded during the raid, with one of the wounded being miraculously rescued floating unconscious out to sea with a head wound. He had been given up for dead when he returned to his unit fourteen days later. The fatalities and casualties all occurred when the enemy hit an ammunition ship adjacent to where 24 Batswana members of the African Pioneer Corps (APC) 1979 Smoke Company where posted.
Thereafter, the dozen surviving members of the unit distinguished themselves for their efficiency in putting up and maintaining smokescreens in their sector, which was credited with saving additional shipping. For his personal heroism in rallying his men following the initial explosions Company Corporal Chitu Bakombi was awarded the British Empire Medal, while his superior officer, Lieutenant N.F. Moor was later given an M.B.E.
Remember: bricks and cement are used to build a house, but mutual love, respect and companionship are used to build a HOME. And amongst His signs is this: He creates for you mates out of your own kind, so that you may find contentment (Sukoon) with them, and He engenders love and tenderness between you; in this behold, there are signs (messages) indeed for people who reflect and think (Quran 30:21).
This verse talks about contentment; this implies companionship, of their being together, sharing together, supporting one another and creating a home of peace. This verse also talks about love between them; this love is both physical and emotional. For love to exist it must be built on the foundation of a mutually supportive relationship guided by respect and tenderness. As the Quran says; ‘they are like garments for you, and you are garments for them (Quran 2:187)’. That means spouses should provide each other with comfort, intimacy and protection just as clothing protects, warms and dignifies the body.
In Islam marriage is considered an ‘ibaadah’, (an act of pleasing Allah) because it is about a commitment made to each other, that is built on mutual love, interdependence, integrity, trust, respect, companionship and harmony towards each other. It is about building of a home on an Islamic foundation in which peace and tranquillity reigns wherein your offspring are raised in an atmosphere conducive to a moral and upright upbringing so that when we all stand before Him (Allah) on that Promised Day, He will be pleased with them all.
Most marriages start out with great hopes and rosy dreams; spouses are truly committed to making their marriages work. However, as the pressures of life mount, many marriages change over time and it is quite common for some of them to run into problems and start to flounder as the reality of living with a spouse that does not meet with one’s pre-conceived ‘expectations’. However, with hard work and dedication, couples can keep their marriages strong and enjoyable. How is it done? What does it take to create a long-lasting, satisfying marriage?
Below are some of the points that have been taken from a marriage guidance article I read recently and adapted for this purposes.
POSITIVITY Spouses should have far more positive than negative interactions. If there is too much negativity — criticizing, demanding, name-calling, holding grudges, etc. — the relationship will suffer. However, if there is never any negativity, it probably means that frustrations and grievances are not getting ‘air time’ and unresolved tension is accumulating inside one or both partners waiting to ‘explode’ one day.
“Let not some men among you laugh at others: it may be that the (latter) are better than the (former): nor let some women laugh at others: it may be that the (latter) are better than the (former): nor defame nor be sarcastic to each other, nor call each other by (offensive) nicknames.” (49:11)
We all have our individual faults though we may not see them nor want to admit to them but we will easily identify them in others. The key is balance between the two extremes and being supportive of one another. To foster positivity in a marriage that help make them stable and happy, being affectionate, truly listening to each other, taking joy in each other’s achievements and being playful are just a few examples of positive interactions. Prophet Muhammad (PBUH) said: “The believers who show the most perfect faith are those who have the best character and the best of you are those who are best to their wives”
Another characteristic of happy marriages is empathy; understanding your spouses’ perspective by putting oneself in his or her shoes. By showing that understanding and identifying with your spouse is important for relationship satisfaction. Spouses are more likely to feel good about their marriage and if their partner expresses empathy towards them. Husbands and wives are more content in their relationships when they feel that their partners understand their thoughts and feelings.
Successful married couples grow with each other; it simply isn’t wise to put any person in charge of your happiness. You must be happy with yourself before anyone else can be. You are responsible for your actions, your attitudes and your happiness. Your spouse just enhances those things in your life. Prophet Muhammad (PBUH) said: “Treat your women well and be kind to them for they are your partners and committed helpers.”
Successful marriages involve both spouses’ commitment to the relationship. The married couple should learn the art of compromise and this usually takes years. The largest parts of compromise are openness to the other’s point of view and good communication when differences arise.
When two people are truly dedicated to making their marriage work, despite the unavoidable challenges and obstacles that come, they are much more likely to have a relationship that lasts. Husbands and wives who only focus on themselves and their own desires are not as likely to find joy and satisfaction in their relationships.
Another basic need in a relationship is each partner wants to feel valued and respected. When people feel that their spouses truly accept them for who they are, they are usually more secure and confident in their relationships. Often, there is conflict in marriage because partners cannot accept the individual preferences of their spouses and try to demand change from one another. When one person tries to force change from another, he or she is usually met with resistance.
However, change is much more likely to occur when spouses respect differences and accept each other unconditionally. Basic acceptance is vital to a happy marriage. Prophet Muhammad (PBUH) said: “It is the generous (in character) who is good to women, and it is the wicked who insults them.” “Overlook (any human faults) with gracious forgiveness.” (Quran 15:85)
COMPASSION, MUTUAL LOVE AND RESPECT
Other important components of successful marriages are love, compassion and respect for each other. The fact is, as time passes and life becomes increasingly complicated, the marriage is often stressed and suffers as a result. A happy and successful marriage is based on equality. When one or the other dominates strongly, intimacy is replaced by fear of displeasing.
It is all too easy for spouses to lose touch with each other and neglect the love and romance that once came so easily. It is vital that husbands and wives continue to cultivate love and respect for each other throughout their lives. If they do, it is highly likely that their relationships will remain happy and satisfying. Move beyond the fantasy and unrealistic expectations and realize that marriage is about making a conscious choice to love and care for your spouse-even when you do not feel like it.
Seldom can one love someone for whom we have no respect. This also means that we have to learn to overlook and forgive the mistakes of one’s partner. In other words write the good about your partner in stone and the bad in dust, so that when the wind comes it blows away the bad and only the good remains.
Paramount of all, marriage must be based on the teachings of the Noble Qur’an and the teachings and guidance of our Prophet Muhammad (PBUH). To grow spiritually in your marriage requires that you learn to be less selfish and more loving, even during times of conflict. A marriage needs love, support, tolerance, honesty, respect, humility, realistic expectations and a sense of humour to be successful.
The past week or two has been a mixed grill of briefs in so far as the national employment picture is concerned. BDC just injected a further P64 million in Kromberg & Schubert, the automotive cable manufacturer and exporter, to help keep it afloat in the face of the COVID-19-engendered global economic apocalypse. The financial lifeline, which follows an earlier P36 million way back in 2017, hopefully guarantees the jobs of 2500, maybe for another year or two.
It was also reported that a bulb manufacturing company, which is two years old and is youth-led, is making waves in Selibe Phikwe. Called Bulb Word, it is the only bulb manufacturing operation in Botswana and employs 60 people. The figure is not insignificant in a town that had 5000 jobs offloaded in one fell swoop when BCL closed shop in 2016 under seemingly contrived circumstances, so that as I write, two or three buyers have submitted bids to acquire and exhume it from its stage-managed grave.