Most ESWL is carried out when the stone is present near the renal pelvis. ESWL involves the use of a lithotriptor machine to deliver externally applied, focused, high-intensity pulses of ultrasonic energy to cause fragmentation of a stone over a period of around 30–60 minutes. Following its introduction in the United States in February 1984, ESWL was rapidly and widely accepted as a treatment alternative for renal and ureteral stones. It is currently used in the treatment of uncomplicated stones located in the kidney and upper ureter, provided the aggregate stone burden (stone size and number) is less than 20 mm (0.8 in) and the anatomy of the involved kidney is normal.For a stone greater than 10 millimetres (0.39 in), ESWL may not help break the stone in one treatment; instead, two or three treatments may be needed. Some 80-85% of simple renal calculi can be effectively treated with ESWL. A number of factors can influence its efficacy, including chemical composition of the stone, presence of anomalous renal anatomy and the specific location of the stone within the kidney, presence of hydronephrosis, body mass index, and distance of the stone from the surface of the skin.Common adverse effects of ESWL include acute trauma, such as bruising at the site of shock administration, and damage to blood vessels of the kidney. In fact, the vast majority of people who are treated with a typical dose of shock waves using currently accepted treatment settings are likely to experience some degree of acute kidney injury.
Varicella - Small ulcers on the back of the oral cavity and vesicular lesions on the scalp and trunk are common for Varicella. It is ruled out as the location of the infections are unilateral, unlike herpetic gingivostomatitis which is bilateral. Treatment
The aim of treatment is mostly supportive such as pain control, duration of symptoms, viral shedding and in some cases, preventing outbreak. Antibiotics are rarely prescribed to treat bacterial superinfection of oral lesions. Antiviral drugs are used to treat herpetic gingivostomatitis such as aciclovir, valaciclovir, famciclovir, and in resistance cases foscarnet can be used. Treatment does not prevent recurrence. Most individuals who are immunocompetent will fully recover from recurrent herpes labialis in 7 to 14 days. However treatment with antipyretics, oral anaesthetics and analgesics is often needed. In severe cases of herpetic gingivostomatitis, mouth rinses are useful in relieving oral discomfort. These contain topical anaesthetic agents such as lidocaine and diphenhydramine as well as coating agents such as magnesium-containing antacids. In order to prevent dehydration, oral fluid intake is encouraged. Other treatment options include good oral hygiene and gentle debridement of the mouth. A number of precautions can be taken to reduce the risk of infection of HSV including;

Avoid saliva exchange with those with active HSV
Avoid direct contact with active lesions (if contact occurred, ensure area is washed adequately)
Those with recurrent HSV can apply sunscreen lip balm as ultraviolet light is a stimulus for the infection

Epidemiology
See also
Acute necrotizing ulcerative gingivitis

References
External links

Underlying Causes at wrongdiagnosis.com
CDC Case Definition: Mercury (Elemental)