Differential diagnosis
A renal colic must be differentiated from the following conditions:
biliary colic and cholecystitis
aortic and iliac aneurysms (in older patients with left-side pain, hypertension or atherosclerosis)
interstitial: appendicitis, diverticulitis or peritonitis (in this case patients prefer to lie still rather than being restless)
gynaecological: endometriosis, ovarian torsion and ectopic pregnancy
testicular torsion

Treatment
Most small stones are passed spontaneously and only pain management is required. Above 5 mm (0.20 in) the rate of spontaneous stone passage decreases. NSAIDs (non-steroidal anti-inflammatory drugs), such as diclofenac or ibuprofen, and antispasmodics like butylscopolamine are used. Although morphine may be administered to assist with emergency pain management, it is often not recommended as morphine is addictive and raises ureteral pressure, worsening the condition. Vomiting is also considered an important adverse effect of opioids, mainly with pethidine. Oral narcotic medications are also often used.There is typically no antalgic position for the patient (lying down on the non-aching side and applying a hot bottle or towel to the area affected may help). Larger stones may require surgical intervention for their removal, such as shockwave lithotripsy, laser lithotripsy, ureteroscopy or percutaneous nephrolithotomy. Patients can also be treated with alpha blockers in cases where the stone is located in the ureter. References


== External links ==
Japanese encephalitis vaccine is a vaccine that protects against Japanese encephalitis. The vaccines are more than 90% effective. The duration of protection with the vaccine is not clear but its effectiveness appears to decrease over time. Doses are given either by injection into a muscle or just under the skin.It is recommended as part of routine immunizations in countries where the disease is a problem. One or two doses are given depending on the version of the vaccine. Extra doses are not typically needed in areas where the disease is common. In those with HIV/AIDS or those who are pregnant an inactivated vaccine should be used. Immunization of travellers who plan to spend time outdoors in areas where the disease is common is recommended.The vaccines are relatively safe. Pain and redness may occur at the site of injection. As of 2015, 15 different vaccines are available: some are based on recombinant DNA techniques, others weakened virus, and others inactivated virus.The Japanese encephalitis vaccines first became available in the 1930s. It is on the World Health Organizations List of Essential Medicines. Efficacy
Randomized control trials on JE-VAX have shown that a two-dose schedule provides protection for one year. History
Japanese encephalitis vaccines first became available in the 1930s. One of them was an inactivated mouse brain-derived vaccine (the Nakayama and/or Beijing-1 strain), made by BIKEN and marketed by Sanofi Pasteur as JE-VAX, until production ceased in 2005. The other was an inactivated vaccine cultivated on primary hamster kidney cells (the Beijing-3 strain).