Renal Stones or Kidney Stones

Posted: March 14, 2013 in Uncategorized

Renal stones is Malaysia is indeed a very common disease. It is also unfortunately one of the main causes of renal failure. You must have heard of patients complaining renal stones pain are the worst pain they ever had and usually require very strong analgesia or painkillers like pethidine, which is super bad for you.


What causes renal stones?Anyone may develop a kidney stone, but people with certain diseases and conditions (see below) or those who are taking certain medications are more susceptible to their development.

Urinary tract stones are more common in men than in women.

A family history of kidney stones is also a risk factor for developing kidney stones. Kidney stones are more common in Asians and Caucasians.

Kidney stones form when there is a decrease in urine volume and/or an excess of stone-forming substances in the urine. The most common type of kidney stone contains calcium in combination with either oxalate or phosphate. About 75% of kidney stones are calcium stones.

A number of different medical conditions can lead to an increased risk for developing kidney stones:

  • Gout results in chronically increased amount of uric acid in the blood and urine and can lead to the formation of uric acid stones.
  • Hypercalciuria (high calcium in the urine), another inherited condition, causes stones in more than half of cases. In this condition, too much calcium is absorbed from food and excreted into the urine, where it may form calcium phosphate or calcium oxalate stones.
  • Hyperparathyroidism, kidney diseases such as renal tubular acidosis, and other inherited metabolic conditions, including cystinuria and hyperoxaluria.
  • Chronic diseases such as diabetes and high blood pressure (hypertension) are also associated with an increased risk of developing kidney stones.
  • People with inflammatory bowel disease are also more likely to develop kidney stones.
  • Those who have undergone intestinal bypass or ostomy surgery are also at increased risk for kidney stones.
  • Some medications also raise the risk of kidney stones. These medications include some diuretics, calcium-containing antacids, and the protease inhibitor indinavir (Crixivan), a drug used to treat HIV infection.
  • Dietary factors and practices may increase the risk of stone formation in susceptible individuals. In particular, inadequate fluid intake predisposes to dehydration, which is a major risk factor for stone formation. Other dietary practices that may increase an individual’s risk of forming kidney stones include a high intake of animal protein, a high-salt diet, excessive sugar consumption, excessive vitamin D supplementation, and possible excessive intake of oxalate-containing foods such as spinach. Interestingly, low levels of dietary calcium intake may alter the calcium-oxalate balance and result in the increased excretion of oxalate and a propensity to form oxalate stones.

A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, these signs and symptoms may occur:

  • Severe pain in the side and back, below the ribs
  • Pain that spreads to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent urge to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

While a CT is most commonly used to visualise and diagnose renal stone, an ultrasound may also be used to confirm this diagnosis.




If you have any of the above symptoms, do not waste time. These ultrasounds are painless, takes only half hour and a report of confirmed diagnosis will be made available on the same day. The cost is RM120. Call Zyla for appointment at 07-5544511.


Here at ScanLab, the ultrasound we most often performed is the upper abdomen ultrasound to rule out gallstones and gallbladder inflammation.

How common are they in Malaysia? There is no exact figure because not many cases undergo investigations but most GP would see at least two cases of gallstone or gallbladder inflammation every day.

What exactly is gallstone disease?

Let’s learn some medical terms. Gallstone in the gallbladder is Cholelithiasis.  Choledocholithiasis  is stones in common bile duct, and is one of the complications of cholelithiasis.

Patient typically complains of sudden pain the the right upper quadrant or the middle of the abdomen, often associated with vomiting and or fever. The pain is usually sharp and spiky but can also be a dull throbbing sensation, and may radiate up to the shoulder blades. The attack usually occur after a fatty meal.

However, many people with gallstones have never had any symptoms. The gallstones are often found during a routine x-ray, abdominal surgery, or other medical procedure.

If a large stone blocks either the cystic duct or common bile duct (called choledocholithiasis), you may have a cramping pain in the middle to right upper abdomen. This is called biliary colic. The pain goes away if the stone passes into the first part of the small intestine (the duodenum). If this does not happen, you might develop yellowing of the eyes and skin. This is called “jaundice”.


What makes a gallstone? There are two main types of gallstones:

  • Stones made of cholesterol, which are by far the most common type. Cholesterol gallstones have nothing to do with cholesterol levels in the blood.
  • Stones made of bilirubin, which can occur when red blood cells are being destroyed (hemolysis). This leads to too much bilirubin in the bile. These stones are called pigment stones.


Why do I get gallstones?

This is a gallbladder full of gallstones

Gallstones are more common in women and people over age 40. Gallstones may also run in families. In other countries, it is common in Hispanics and Native Americans.

The following also make you more likely to develop gallstones:

  • Bone marrow or solid organ transplant
  • Diabetes
  • Failure of the gallbladder to empty bile properly (this is more likely to happen during pregnancy)
  • Liver cirrhosis and biliary tract infections (pigmented stones)
  • Medical conditions that cause the liver to make too much bilirubin, such as chronic hemolytic anemia, including sickle cell anemia
  • Rapid weight loss from eating a very low-calorie diet, or after bariatric surgery
  • Receiving nutrition through a vein for a long period of time (intravenous feedings)


Tests used to detect gallstones or gallbladder inflammation include:

The first test your doctor would order is upper abdominal ultrasound. The radiologist can confirm the diagnosis of cholelithiasis with an abdominal ultrasound that shows the ultrasonic shadows of the stones in the gallbladder.

You will be able to see the gallstone inside the gallbladder yourself during the ultrasound.

Abdominal ultrasound is an imaging procedure used to examine the internal organs of the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. The blood vessels that lead to some of these organs can also be looked at with ultrasound.

The other tests are usually performed once complications of gallstones, for example jaundice, occur.

How the abdominal ultrasound is performed

An ultrasound machine creates images that allow various organs in the body to be examined. The machine sends out high-frequency sound waves, which reflect off body structures to create a picture. A computer receives these reflected waves and uses them to create a picture. Unlike with x-rays or CT scans, there is NO ionizing radiation exposure with this test.

You will be lying down facing the ceiling on the examination couch for the procedure. A clear, water-based conducting gel is applied to the skin over the abdomen. This helps with the transmission of the sound waves. A handheld probe called a transducer is then moved over the abdomen.

You may be asked to change position so that the health care provider can examine different areas. You may also be asked to hold your breath for short periods of time during the examination.

The procedure usually takes less than 30 minutes.

Preparation for the procedure depends on the nature of the problem and your age. Usually patients are asked to not eat or drink for several hours before the examination. We will give you specific instruction the day before your procedure appointment.

There is no pain. The conducting gel may feel slightly cold and wet. This is wiped away with tissue paper once the test is completed.

Antenatal Ultrasound RM40

Posted: November 7, 2012 in Uncategorized


We have been getting many visits to the clinic and even more phone inquires regarding our services at ScanLab, and we just must say THANK YOU!!! We hope to see more of you here because we need to take charge of our health.

We get a lot of enquiries regarding antenatal ultrasound since it is not listed in the pricing schedule. We would like to announce, yes, of course we do antenatal ultrasound here at ScanLab. We had not listed it because many general practitioners and obstetricians out there offer the same, but same item does not translate into same service perhaps?

Our normal ultrasound cost RM40 while our 4D ultrasound is priced at RM85.

We’ll come back tomorrow to discuss more about 4D ultrasound since a lot of mommies out there have a lot of questions about the exciting 4D scans:)

Breast Cancer Awareness Month

Posted: October 12, 2012 in Uncategorized

October is Breast Cancer Awareness Month. Why awareness for breast cancer is so important is because early detection saves lives. One in 19 Malaysians will develop breast cancer in the course of their lives. What is your breast cancer risk?

Early detection as in detection in Stage 1 or 2 increases the rate of recovery with a whooping 90% chance of survival. Compare this with discovery at Stage 4 where chance of survival is so slim at 10%.

With a family history of breast cancer, the risk of a woman getting breast cancer also increases. If she has a mother or sister with breast cancer, she now has a two fold increase in her risk of being diagnosed with the same. (This translate the average risk of 1 in 20 to 1 in 10)

When is something not right? The current catchphrase is Know Your Breast. Be it dimpling of the skin, nipple inversion, hardened area or a breast lump, you need to discuss with your doctor if you notice any change. Be diligent with self breast examination and have a medical check up at least once a year.

Worldwide, women in their 50-70s are invited for breast screening at least once every 3 years. In Malaysia, many are eligible for FREE mammograms. Mammograms are recommended for women above age 40 while breast ultrasound is recommended for women below 40. In some cases, your doctor might order one after the other. Obviously someone with a positive family history should be screened from a younger age and investigated more thoroughly.

At least we can say this about breast cancer- Screening Saves Lives.

What is a breast ultrasound?

Posted: September 19, 2012 in Uncategorized

A  breast ultrasound is a test your clinician might order when you present with a breast lump or an abnormality is seen on a mammogram. A general rule of thumb many clinician use as a screening tool for breast cancer is breast ultrasound for females under forty years of age and mammogram for females above forty. The reason to this is young breast are usually very dense and a mammogram might miss a lesion.

The procedure is simple. You will ask to undress from waist up and a gown will be given for you to wear. You will lie on the examination cough. A probe connected to the ultrasound machine will be placed on your breast and you can see its images on the screen.

Here in ScanLab, you may bring a family member to accompany you through out the procedure.

Ultrasound is safe and painless. Ultrasound images are captured in real time so they can show structure and movement.

After the test, you will be asked to get dressed while the radiology specialist prepare a report.

You need to take this report to your clinician for further management advice or see our resident doctor.

This test takes between 30 minutes to one hour.

Two important radiology professional organizations — the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) — have released recommendations on breast cancer screening. The recommendations were published in the January 2010 issue of The Journal of the American College of Radiology.

The recommendations say:

  • Women with average breast cancer risk should start annual mammograms at age 40.
  • Women with a much higher-than-average risk of breast cancer should start breast cancer screening at least by age 30, but not before age 25.
  • Women with a 20% or higher risk of breast cancer are considered to be at much higher-than-average risk. This includes women with an abnormal breast cancer gene (BRCA1 or BRCA2).
  • Women at much higher-than-average risk need a customized screening plan; this custom plan might include breast ultrasound and breast MRI as well as an annual mammogram.
  • Ultrasound (in addition to an annual mammogram) should be strongly considered as a screening tool for women at higher-than-average risk with dense breasts.

The above is quoted from

While we do not have mammogram facility at our premise, we take this opportunity to share the fact that having regular mammograms can lower the risk of dying from breast cancer. If you are age 50 to 74 years, be sure to have a screening mammogram every two years. If you are age 40–49 years, talk to your doctor about when and how often you should have a screening mammogram.

Visit for more detailed information regarding the procedure.


Posted: September 18, 2012 in Uncategorized

Who needs a breast ultrasound? One in seven adult females develop breast cancer.

Here at ScanLab, you may get referred by your clinician or you can refer yourself for an ultrasound and get reviewed by our own resident doctor. These prices reflect  the ultrasound and its report.

Upper Abdomen Ultrasound RM60

Lower Abdomen/Pelvis Ultrasound RM120

Breast Lump Ultrasound RM120

Prostate Enlargement Ultrasound RM100

Thyroid Swelling Ultrasound RM120

Carotid Arteries Ultrasound RM300

Renal Arteries Doppler/Ultrasound RM300

Musculoskeletal Ultrasound from RM 100

Please ask for recommendations if you are unsure about the correct ultrasound you require.

We look forward to your visit. We cater for after hour appointments.

Call us at 07-5544511