ETIOLOGY OR THE CAUSE OF KIDNEY STONE

ETIOLOGY OR THE CAUSES OF THE KIDNEY STONES

In laboratory experiment, urinary stone can be regularly produced by diets low in vitamin A. It may be secondary to the epithelial degeneration which occurs in vitamin A deficiency in rats.
In patients with hyperparathyroidism, the urinary stone formation may be related the markedly increased excretion of calcium in the urine.
Stone formation appears often to be secondary to in infection in the kidney. Clumps of bacteria and epithelial and pus cells may act as the nuclei for stone formation.
During World War II, in troops living in a hot dry climate, with inadequate water intake and a diet containing vegetables with a high oxalate content, oxalate crystals may be precipitated in urinary tract. These crystals are irritants and may produce gross hematuria [blood in the urine], symptoms of renal or kidney colic or and cystitis. On cystoscopy [visual examination of the bladder] there is an intense inflammation, and oxalate crystals can be seen embedded in the mucosa. The fibrin formed as a result of bleeding provides a matrix for the formation of calcium oxalate stones. Unless obstructive stone have been formed, the symptoms of oxalate in the urine are relieved promptly by an increased fluid intake.
The other stones appear, however, to arise in aseptic urine, begin when urine become super-saturation with insoluble components due to low volume, excessive excretion of selected compound, and changes of pH [pH 7 is neutral, less than 7 is acid and more than 7 is base or alkaline solution].
Approximately 75 % of stones are calcium-based [ the majority are calcium oxalate, calcium phosphate and other mixed stones], 15 % struvite [magnesium-ammonium-phosphate], 5 % uric acid and 1 % cystine, depending on the metabolic disturbances from which they arise. Struvite is the most common component of stag-horn stone.
The surface of stone such as uric acid,, carbonate, cystine stone are generally smooth. The surface of calcium oxalate stones and phosphate stone are generally rough; the large stone of calcium oxalate is uneven surface, which is classed as a mulberry stone.
In determining the nature of the sediment or stone formed the pH is a control factor.
Determination of urine solution by litmus paper as indicator: acid urine turns the litmus to red color, and base or alkali urine turns the litmus to blue color.
Uric acid tends to precipitate when acidity becomes high at pH 5, At pH 6 mixed stones of uric acid, sodium urate, calcium oxalate and phosphate will tend to form. At pH 7 calcium phosphate tend to form, between pH 7 and 8 with the urine ammoniac mixed stone of calcium phosphate, magnesium ammonium phosphate, and ammonium urate may form; at high alkali pH 8 or above 8 tend to produce stones containing calcium carbonate, ammonium magnesium phosphate and ammonium urate.
So that the causes of kidney stones are classified :
• Excessive intake and excretion of relatively insoluble urinary constituents
• Increased concentration or super-saturation of urinary constituents when fluid intake is low
• Nucleus [Nidus] for stone formation: Organic material, such as bits of necrotic tissue, blood clot [fibrin], clumps of bacteria if accompanied by infection.
• The nature of the kidney stones formed, the pH is a control factor.

The next subtopic is THE SYMPTOMS AND SIGNS OF KIDNEY STONE

SIMPLE AND LOW COST TREATMENT OF KIDNEY STONES

SIMPLE AND LOW COST TREATMENT OPTION OF KIDNEY STONES, THE WRITER’S EXPERIENCES.


Kidney stone is the stone which formation of concretions in the calices or pelvis of the kidney from the crystalline urinary constituents. The concretions are solid mass of urinary sediment formed in some part of the kidney or urinary tract.
The writer’s experiences treatment of patients for kidney stones since 1968, while the writer was a physician in the Hospital and Municipality Health Services Sibolga City, Tapanuli North Sumatra, Indonesia.
Why the title is simple and low cost?
The experience basic keyword treatment of kidney stones is the base or alkaline substance and base or acid forming foods diet which can dissolve the stones.
What is the basic keyword substance?
The basic substance is such as sodium bicarbonate tablet; it can be substituted with baking soda or baking powder. The base or acid forming foods diet is the daily food intake.
Is it simple? Yes! How is about the cost? Is it a low cost? Yes!!!

The dose of baking soda is one teaspoon dissolve in one glass water 3 times daily,which one teaspoon contain 4800 mg or 4.8 g baking soda.For one day the patient need about 15 g or for one month 450 g or one lb with price about $20,for 3 months is $60
The kidney stone size less than 15 mm diameter,width and length need for one month treatment; kidney stone size 15mm to 25 mm [1 inch] need treatment 1-3 months.
THE SITUATION
The kidney stone vary in shape and size according to the location, the smaller stone, termed sand and gravel, in general arising from the kidney or pelvic portion of the kidney, where as the large stone are ordinary formed in the bladder. The condition in which stones are formed in the human body is termed, lithiasis. So the kidney stone is called also nephrolithiasis. Very large stones may also form in the kidney. One of these, the so called stag-horn stone, may fill the entire central portion of the kidney.
In the early twentieth century the urinary stone frequently found in children may be due to nutrition and vitamins deficiency and now primary disease of old age, more than half of persons admitted for operation being between the age of 50 and 70. Kidney stone is about three times as common in males as in females. The kidney stones are affecting about one percent of the population, and recurrent is about a half of the suffering.

WHAT ARE THE PROBLEMS ?
What are the causes of kidney stones [KSs]?
What are the symptoms and signs of KSs?
How to examine and diagnose the KSs?
How are the prognosis of KSs?
How to treat and prevent the KSs?
What about the cost of treatment KSs?
The answers to these questions or problem solving in the next subtopic:

THE ETIOLOGY OR THE CAUSES OF KIDNEY STONES

EXPERIENCES: MEDICATION AND DIET TREATMENT OF PILES

WRITER’S EXPERIENCES: MEDICATION AND

DIET TREATMENT OF HEMORRHOIDS [PILES].
IT SEEMS PRIME RESTITUTION AND LOW COST.

The first experience in 1982, when the writer had hemorrhoid or pile in stage 1, two small masses [diameter was about 5 mm ] protruded in the anus after defecation, with mild pain and itching while in perspiration, but no bleeding, and push back spontaneously. The piles may increase if the writer eat the food with hot chili and peppers.
The treatment according to the references available were general and local measures combine with antibiotic tetracycline and sulfadiazine or chloramphenicol and other sulfadiazine derivatives. Treatment for 6 months had no improvement or healed.
Then the writer studied more the references about the cause and treatment of piles, and had a temporary conclusion that the basic caused of piles was multiple infections and inflammations in rectum and anus had the long run effects on the veins circulations as describe in paragraph about the cause of piles. The treatment should be broad-spectrum antibiotics and anti microbial, anti protozoa [ameba,trichomoniasis, giardiasis] and anti anaerobic bacteria [clostridia, pepto-coccus, bacteroides fragilis]. The drugs available for these criterias of treatment were Terramycin [brand name, generic: oxytetracycline] and Fasigyn [brand name, generic: tinidazole].
The doses were: Terramycin 250 mg/capsule thrice 500 mg daily for 5 days and Fasigyn 500 mg/tablet once 2 gram daily for 3 days, combined with vitamin B-Complex, C and A. What was the result? Amazing ! The pile was healed in one week until today.

Since 1982 the writer treats the pile of patients with Terramycin and Fasigyn;
Adult dose: If body weight less than 60 kg, Fasigyn 500 mg/tablet once 3 tablet per oral daily for 4 days and Terramycin twice 2 capsule daily for 5 days. If the body weight more than 60 kg, Fasigyn 500 mg/tablet once 4 tablet per oral daily for 3 days, and Terramycin 250 mg/capsule thrice 2 capsule daily for 5 days, combined with vitamin B-Complex, C and A. If Fasigyn is not available, we can change with metronidazole 500 mg/tablet , the dose is the same with Fasigyn.
The side effects of Fasigyn and tinidazole are feeling of mild dry and mild bitter taste in mouth during treatment [3-5 days].
Fasigyn and tinidazol or metronidazole are contraindicated in first trimester pregnant women [the research in animal found fetotoxic effect in first trimester but not in women] , safe is safe it can be given or treat in the third trimester of pregnant women for piles or after delivery. Terramycin is contraindicated for pregnant women because of fetotoxic effects, it can be replaced with spiramycin 500 mg/tablet thrice daily for 5 days.
The vitamin B-Complex effects to prevent side effects of antibiotics
and antimicrobial; vitamin A 20 000 IU daily to strengthen the epithelium of the
mucous membrane,
and vitamin C 500-1000 mg daily strengthen the collagen structure of connective
tissue it necessary plays an important role in the laying-down of the new
connective tissue which is essential to healing of mucous
membrane and better vascular of blood vessel .
Treatment of multiple infections and inflammations combine with vitamin A and C may have effects to heal and to paste the lax mucous membrane in piles to sub-mucous and smooth muscle of anus and rectum .
If the piles with bleeding the additional treatment vitamin K 5 mg once per oral daily and Adona [brand name, generic: carbazochrom sodium sulfonate] 10 mg/tablet per oral 3 times daily. For itching give anti histamine such as Phenergan 10 mg twice daily.
The children dose : Terramycin for children is 20-25 mg/kg body weight in two divided doses, and the dose of Fasigyn for children is 50-60 mg/kg body weight as single dose.

The diet treatment: Mild food or steam food during treatment. Avoid hard food and hot chili and pepper foods in the period of treatment and one month after treatment. After one month period to prevent recurrent piles, advice to the patients can eat mild hot chili and pepper foods and better no hot chili and pepper food.
Additional diet fruit treatment particularly with papaya and pineapple which contain proteinase enzyme such as papain .The action of papain is proteolytic enzyme activated by present of H2S [hydro sulfide] keratin-ase enzyme which catalyze hydrolytic reactions of keratin proteins to end products polypeptide and amino acids. [Source: Philip B. Hawk et al. 1954, p 157, 306, 317].
The portion of these fruits during treatment: papaya one cup 3-4 times daily, the pineapple the same 1 cup 3-4 times daily for 5 days; and then a half cup twice daily of papaya and pineapple respectively for preventive, other fruits are optional.
The mechanism action of these fruit are not clear, may be the proteolytic and hydrolysis reactions of proteins by papain in the phlebitis of veins, may open the occlusion and better flow of blood in the veins plexus of hemorrhoids.

Since 1982 the writer had a few patients stage 1, 2 and 3 [no case stage 4] every year , all were healed or relieved; those only 2 recurrent patients due to eat the very hot chili and peppers food. And after treated with Fasigyn,Terramycin and diet, both patients relieved. The recurrent piles may be because of large hot chili and peppers eaten by the patients caused inflammations of mucous membrane in rectum and anus, which induced piles.

The experiences medical and diet treatment of hemorrhoids or piles, non-surgical treatments. It seems prime restitution, because all relieved since 1982 and only 2 recurrent patients, and relieved after treatment with the same method.

These experiences need a further extended clinical trial and research in the hospital, health center or research center. The result of research and extended clinical trial might be the input for public health prevention and treatment of piles.
The writer’s friend physicians and health office services, the readers, families and friends, please try to apply this non-surgical, medicated treatment and diet of piles, it seems prime restitution and low cost treatment.
GOOD LUCK!!!

Hope and believe the patients relieved,
and let us sing: AMAZING GRACE !!!

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TREATMENT OPTION OF HEMORRHOIDS [PILES]

TREATMENT OPTION OF HEMORRHOIDS [PILES]

1. General and local measures
2. Schlerosant injection
3. Surgical treatment
4. The writer's experiences with medication and diet treatments
.
1. General measures for stage 1, 2 and 3: Control constipation by laxative drugs such as mineral oil 15-50 ml per oral at bed time; Dulcolax [brand name, generic bisacodyl ] 5 mg /tablet per oral 10 mg or suppository 10 mg at bed time; Tegaserod 2-4 mg twice per oral daily for chronic constipation.
Local measures: lubricant [petrolatum] to anal region, local anesthetic ointments for pain relief. Warm sit baths, 20-30 minutes twice daily. Rubber band ligation for internal piles only; if for external piles can effect very severe pain.The general and local measures can only reduced piles but do not heal the piles.
2. Schlerosant injection : Injection is applicable for the small internal piles [stage 1 and 2]. Injection of piles with 1 ml of 0.5 % quinine solution or
solution phenol 5 % in vegetable oil through a 22-gauge needle in one day and
repeated injections may be necessary
The piles may relief after a few injection. The complication of schlerosant
injection is about 2 %
including bleeding, urinary retention and pelvic abscess. Recurrence is
common unless patients alter dietary habits to advisable diet.
3. Surgical treatments [hemorrhoidectomy]:
Generally speaking, uncomplicated external and internal hemorrhoids usually are treated by clamp and cauterization, ligature operations of hemorrhoids. For the 4th stage and complicated piles of hemorrhoids one of varieties of hemorrhoidectomy is the Whitehead operation.
[a] Clamp and cauterization operation is used for both internal and external piles [stage 2 and 3] The sphincters are dilated, each pile grasp in turn, the external muco-cutaneous folds divided to the vascular pedicle, which is crushed by a clamp applied in the long axis of the bowel. Protecting the skin under the clamp with wet gauze, the pile is slowly burned away by a cauterization at dull red heat. The procedure is repeated with each pile, taking care not to dilate the anus again for fear of hemorrhage. The boric acid ointment is then freely applied on a gauze pad held by a T-bandage.
[b] Ligature method: The pile is exposed and liberated to the vascular pedicle as in the clamp and cauterization method. The pedicle is then ligate with catgut or silk.
[c] Whitehead’s operation: Excision of the pile-bearing area of mucous membrane has been used for very extensive pile [stage 4] conditions. The upper edge of the divided rectal mucosa is brought down and sutured to the anal margin after the excision.

The complication of operation: The operation may be followed by hemorrhage, laceration; injury and perforation of the rectum, persistent stricture [narrowing of the rectum], or stenosis [stricture] of the anus

How much the cost treatment of piles?
Estimated cost for treatment of piles by Jerry Holloway the author of “Destroy Hemorrhoids” said that the details of the cost:
• Leading hemorrhoid Ointment….$11.99
• 5-Pack Anti-Inch Cream…...…......$37.45
• Hemorrhoid Seat Cushion….….....$22.99
• Doctor’s Appointments…..…......$1075.00
• Prescription Ointments[3 tubes].$213.96
• “Preparation” Suppositories……....$18.99
• Hemorrhoids Surgery..$9 000-12 000.00
• TOTAL:……………………$13, 380.38…
This total cost of hemorrhoids treatment is expensive for middle and low income groups.

How much the cost for Writer’s experiences treatment of hemorrhoids?

The cost in Jakarta Indonesia is estimated less than $ 20.00 The cost in USA may be less than $ 50.00.
The cost for hemorrhoids surgery in Jakarta is about $2 000-3 000.00 .It is expensive for middle and low income groups.

PROBLEMS OF HEMORRHOIDS, TREATMENT OPTION AND COST

PROBLEMS OF HEMORRHOIDS, TREATMENT OPTION AND COST

What is the hemorrhoid?
Hemorrhoids or piles are ano-rectal varicose dilatation involving the hemorrhoids plexus of veins, there are lax pelvic veins and venous stasis Inadequate peri-vascular support and the absence of valves permit reversed venous flow in the hemorrhoids plexus.
The writer experiences for medication and diet treatment of piles, had good result or relief since 1982, it seems prime restitution.
The description is on the treatment option.

The situation:
A part of women have hemorrhoids, which often develop during pregnancy or delivery, sedentary habits, erect posture, and venous congestion and dilatation accentuate these varicoses. Hemorrhoids can occur at any age and affect both sexes female and male.
Hereditary factors may predispose to piles.
What types or varieties of piles? There are external and internal piles.
External piles are those of the inferior hemorrhoids plexus, are covered by anal skin and arise below the ano-rectal line.
Internal piles implicate the superior hemorrhoids plexus of veins, are covered by mucous membrane and have their origin above the ano-rectal line.

What is the problem?
What are the causes, symptoms and signs of hemorrhoids?
Can we treat hemorrhoids?
What are the option of treatments?
What are the potential complication of treatments?
How much the cost treatment of piles by option?

The answers for problem solving are the following description:

Problem solving:
The cause of piles
The causes include reduced vascular drainage of the pelvic organs such as pregnancy, constipation; repeated trauma to rectum and anus due to sodomy , sexual perversion, large and hard stool which can followed by mucousal fissures, infection and ruptured blood vessels and increased venous pressure in portal hypertension. Bacterial infection may develop in the venous circulation, producing peri-phlebitis and endo-phlebitis.
Bacterial infection may cause proctitis or rectitis [inflammation of the rectum] due to staphylococcus, streptococcus, pseudomonas aeroginosa, gonorrhea, lymphopathya venereum, amebiasis dysentery, anaerobic bacteria
Thrombosis or rupture of vessels often results in slough and ulceration.

Symptoms and signs
There are 4 principle symptoms:
Pruritus ani: the itching is usually localized anal circle; distressing symptoms of a underlying local or general disorder , it occurs because the sensitive, often moist perineal [pudendal] skin is exposed to irritating fecal material retained in anal recesses. The perianal skin may be erythematous [reddish], moist or bleeding.
Pain: mild or severe pain is the result of constriction, edema, or strangulation of piles; severe pain usually in external piles due to the sensitive of the skin; the internal piles mucosa is less sensitive than the skin.
Bleeding: which may be mild or severe occur with mucous laceration, venous distention, obstruction, or ulceration of prolapsed internal piles as a result of straining or difficult defecation.
Prolapse: protrusion of piles may occur suddenly after sub-mucous rupture of veins, thrombosis or strangulation of internal piles.
The stage of pile consists of:
First stage: small protrude of internal mucous of piles or small mass of external piles like polyp, while or after defecation.
Second: protrude of piles larger mass of internal mucous but can reduced spontaneously after defecation; Slight or profuse bright red bleeding, usually at stool with protrusion following defecation, at first reduced spontaneously but later requiring manual replacement; soreness, sense of incomplete evacuation and lumbar discomfort.
Third: protrude of larger mass and can not spontaneously reduced but the piles can be pushed back to above ano-rectal line.
Fourth stage: larger mass protruded and can not be push manually into abdomen above ano-rectal line, it need emergency treatment to prevent strangulation and putrefaction.

Examination and diagnose:
Inspection, palpation and proctoscopy for non protruded piles reveal a globular expansible mass covered by mucous membrane. Protruded piles are visible as protuberant purple nodules covered by mucosa.

COUPLES WHO WISH CHILDREN:SUMMARY AND DISCUSSION

COUPLES WHO WISH CHILDREN: SUMMARY AND DISCUSSION

The name or header of the writer publication is pophealth-fp.blogspot.com. Pophealth-fp is the abbreviation of Popular Health Family Planning. This header emphasize the content of publication are topics of health including reproduction health and family planning.
The first title is COUPLES WHO WISH CHILDREN; generally all couples wish children as a human being can have children naturally.
The situation about 14 % of couples world-wide are childless or infertile and some of them have preference male or female. So that the priority and purpose of description on this writing is how to help the readers, their families and friends by giving information on infertile couples or childless couples; causes, examinations, diagnose and treatments; preference male and preference female births, as parts of the goals and slogan of health and family planning programs.
Health, as it is defined in the constitution of the World Health Organization, is
“ A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
The goal of family planning is to achieve the prosperous happy and small family norms. It is translated to slogans: TWO CHILDREN ARE ENOUGH AND TWO CHILDREN ARE BETTER.
The effects of family planning are to control and lowering the fertility rate and population growth rate to stable population as the base for better life, economic and social developments.
What are the problems? The problem are stalling fertility !
What is stalling fertility?
In Bangladesh, despite increasing contraceptive use, over the past 10 years the total fertility rate [TFR for ages 15-49, the fertility expressed per woman over her lifetime] in that country remained relatively unchanged or stalling fertility, at about 3.3 births per woman. The cause of stalling fertility may be due to the preference for sons among the couples in Bangladesh.
In Indonesia the TFR in 1997 was 2.78, in 2202-03 was 2.60 and in 2007 was 2.60; it seems like stalling fertility , that in the last 5 years the TFR was stable at 2.6.
The cause of stalling fertility in Indonesia may be because of local sub-cultural patriarchal [preference for sons], and matriarchal [preference daughters or girls].
How to solve the problem of preference son [male ] or preference girl [female] and childless or infertile couples?
The main key to solve the problem of preference male and female child and childless couples, please read on the file titles:
Advice to have preference male and female births ,
Advice for couples children births,
Treatment of infertility in the male,
Treatment of infertility in the female.


If medication treatment do not responded, the next step to consult to the Gynecologist for assisted reproductive technologies [ART]. The ART consists of: in vitro fertilization [IVF] and intracytoplasmic sperm injection [ICSI].
The impact of stalling fertility in Indonesia is the population growth still 1.3 % per year or about 3 million increased population per year, it is about the same population of Singapore State.
Stable population can be achieved if the TFR is about 2-2.1 which effects of net reproduction rate is about one [NRR=1, means the replacement level, where woman has only one daughter over her life time]
The plan of action to achieve the goal and the effects of FP are the main activities of information, education and communications [IEC] , IEC on preference male and female births, reproductive health and family planning services such as administration or services of contraceptive pills, implants, condom, intrauterine device [IUD], tubectomy [surgery ligature of uterine tube for female], vasectomy [surgery ligature of vas deference for male].
If the treatment and advices success for the couples, and they get pregnant, the next description is to help the couples: Making pregnancy safer. The description of how to make pregnancy safer , intervention for reducing maternal and neonatal deaths, read the files :
Prevention of abortion; Abortion treatment;
Preterm or premature labor; postpartum hemorrhage and eclampsia; intervention for maternal and neonatal deaths.

Prenatal care for pregnant women to ensure mothers health, and to ensure delivery of a healthy baby, to identify danger sign of pregnancy , treatment and prevention of reproductive tract infection particularly:
Curable sexual transmitted infection [STIs] such as Gonorrhea, Syphilis, Trichomoniasis and Lymphogranuloma venereum [caused by Chlamydia trachomatis] sexual transmitted infections or diseases.
For treatment of pregnant women the physician should be careful to administer or give of drug particularly in the file title:
Drug adverse effects on the fetus; in this writing there is:
List of Drugs Adverse effects on the fetus. [Teratogenic and fetotoxic drugs].
The other activities of prenatal cares are schedule; Visits and examination of pregnancy, and to estimate Expected date of delivery; administration of vitamins and mineral to support pregnancy.
A few experiences of the writers to prevent abortion and hemorrhage by medication and administer supporting vitamins and minerals for women:
[1] Routine administration of vitamins and minerals: vitamin B-Complex, vitamin AD, Calcium lactate and iron sulfate usually per oral intake daily during pregnancy for growth of fetus and prevent anemia.
[2] Additional vitamins which support better fertility and pregnancy with vitamin A, C, and E. The purpose of these vitamins are: Vitamin A for better process of ovulation before pregnancy, combine with sodium bicarbonate[bake powder] twice one gram daily and base forming food diet [vegetables and fruits].These combinations will induce the secretion of cervix,uterus and uterine tube to become base or alkaline, which are favorable media for sperma, then facilitate better fertilization.Vitamin E during the first half of gestation permits normal implantation of fertilize ovum and embryo development, and parturition; vitamin C is concern with the growths of fetus and placenta as such as: formation of intercellular substances, including the collagen tissue, matrices of bone, cartilage and dentin, and all non epithelial cement substance, including vascular endothelium of fetus and placenta.Wound repair,because vitamin C is essensial for regular formation of the reticular structure of the intercellar matrix of connective tissue,it necessary plays an important role in laying-down of new connective tissue which is essential to healing.
These vitamins combine with antispasmodic Buscophan [brand name, generic hyoscine-N-butylbromide] and papaverine , if administered at the early sign of abortion [such as pain on lower abdomen, back pain, little bleeding from vagina] can prevent abortion. It seems good result as prophylaxis and prevent abortion in the experiences of the writer.
[3] Neurotropic and neuromyalgic such as Neurobion tablet which is consists of vitamin B1 100 mg, vitamin B6 200 mg and vitamin B12 200 microgram; these vitamins can treat the nausea , vomiting, fatigue and low back pain in first trimester of pregnancy; and in third trimester can strengthen the Oxytocin to stimulate contraction of uterus in the period of delivery and post delivery, which can prevent hemorrhage in the third phase of delivery, eventually reduced the mortality of the women.
[4] Administration of vitamin K 5 mg per oral daily and vitamin C 500-1000 mg daily in the last month [36-40 weeks ] of pregnancy can support preventing hemorrhage by better clotting of blood during delivery and post delivery. See the file: Labor and delivery.
These experiences might be an input needed for further study in extended clinical trial by Obstetricion and Gynecologist or by hospital, health center and research center.

Hope the extended clinical trial result feedback to: sahalataylor@gmail.com

HOPE THE EXTENDED CLINICAL TRIAL AND RESEARCH WILL SUCCESS.
MAY THE ALMIGHTY GOD KEEP AND BLESS ALL OF US.