A Case of Pure Matrix Ureteral Stone: A rare type of urinary calculi that may be overlooked

Matrix stones are a rare form of urinary calculi with a low mineral content. We report a 63-year-old female patient who presented to the Sohar Hospital, Sohar, Oman, in 2018 with unexplained left flank pain and constipation. She had a history of chronic renal failure (CRF) and had previously undergone haemodialysis (HD). Non-contrast computed tomography (CT) did not show any renal or urinary stones. However, a left-sided ureteroscopy revealed a yellow-coloured stone that was soft in consistency occupying the proximal 5 cm section of the ureter. Many attempts at forceps extraction were required for complete clearance. A global quantitative composition analysis revealed the extracted stone to be composed entirely of protein-matrix material. Matrix stones require a high index of suspicion as they are sometimes radiolucent and cannot be visualised on CT scans. Risk factors include being female and a history of urinary tract infections, CRF and HD.Keywords: Urolithiasis; Ureteral Calculi; Diagnostic Imaging; Ureteroscopy; Case Report; Oman

Sublimation transfer printing of linen and polyester/linen fabrics

147-151An attempt has been made to chemically modify the linen and polyester/linen fabrics via benzylation. Linen fabric is more susceptible to the benzylation reaction than its blend with polyester. The maximum degree of substitution obtained in the case of blend is 0.26 as compared to 0.85 in case of 100% linen when benzylation is conducted for 4h. Partial benzylation of linen and polyester/linen fabrics increases their transfer printability. Partially benzylated printed fabrics have high colour strength and their overall fastness properties are good to very good

Ultras ono graphic and Doppler Evaluation of the Lower Uterine Segment in Pregnant Women with Previous Cesarean Section: Correlation with Intraoperative Findings

Abstract Background: The safety of vaginal birth after cesarean (VBAC) has been confirmed in various clinical trials; however, the possibility of uterine rupture exists. With the availability of ultrasonography, assessment of the integrity of the uterine scar has become possible even in a gravid uterus

Risk factors and prognosis of intravesical recurrence after surgical management of upper tract urothelial carcinoma: A 30-year single centre experience

Objective: To review the incidence, predictors and prognosis of bladder cancer recurrence after management of upper tract urothelial carcinoma (UTUC). Patients and methods: We retrospectively reviewed patients who were surgically treated for UTUC from 1983 to 2013. The tumours were categorised according to the 1997 Tumour-Node-Metastasis (TNM) staging and the three-tiered World Health Organization grading systems. The primary endpoint was the occurrence of any intravesical recurrence after treatment. We studied the possible risk factors that may contribute to development of intravesical recurrence, as well as the prognosis of the patients who had recurrence. Results: In all, 297 patients were eligible for analysis. Recurrent bladder tumours occurred in 139 patients (46.8%). The mean (range) time to recurrence after surgery was 33 (6–300) months. Neither sex, past history of bladder tumours, concomitant bladder tumour, the side of the tumour, UTUC stage, grade, presence of carcinoma in situ or multicentricity at the time of diagnosis of UTUC, were significant predictors of intravesical tumour recurrence. Ureteric tumour was the only identified risk factor (P = 0.02). Post-treatment bladder recurrence was a significant predictor of later urethral recurrence (P = 0.002). Conclusions: In our present series, bladder cancer recurrence of urothelial malignancy occurred in nearly half of the patients after surgical management of UTUC. Ureteric tumour was the only identifiable risk factor, thus patients with ureteric tumours may benefit from prophylactic intravesical chemoimmunotherapy. Bladder recurrence does not appear to affect the cancer-specific survival after surgical management of UTUC

Acute kidney injury following radical cystectomy and urinary diversion: predictors and associated morbidity

ABSTRACT Introduction: Acute kidney injury (AKI) after major surgeries is associated with significant morbidity and mortality. We aim to report incidence, predictors and associated comorbidities of AKI after radical cystectomy in a large cohort of patients. Materials and Methods: We conducted a retrospective analysis of 1000 patients who underwent open radical cystectomy in a tertiary referral center. Perioperative serum creatinine measurements were used to define AKI according to the RIFLE criteria (as Risk, Injury and Failure). The predictors of AKI after surgery were determined using univariate and multivariate analyses. Results: Out of 988 evaluable patients, AKI developed in 46 (4.7%). According to RIFLE criteria; AKI-Risk, AKI-Injury and AKI-Failure occurred in 26 (2.6%), 9 (0.9%) and 11 (1.1%) patients, respectively. Multivariate analysis showed that performing nephroureterectomy with cystectomy (Odds ratio [OR]: 4.3; 95% Confidence interval [CI]: 1.3-13.6; p=0.01) and the development of high grade complications (OR: 3.8; 95% CI 1.9-7.2; p<0.0001) were independently associated with AKI. Conclusions: AKI is a significant morbidity after radical cystectomy and the term should be included during routine cystectomy morbidity assessment

The meteoritic origin of Tutankhamun’s iron dagger blade

Scholars have long discussed the introduction and spread of iron metallurgy in different civilizations. The sporadic use of iron has been reported in the Eastern Mediterranean area from the late Neolithic period to the Bronze Age. Despite the rare existence of smelted iron, it is generally assumed that early iron objects were produced from meteoritic iron. Nevertheless, the methods of working the metal, its use, and diffusion are contentious issues compromised by lack of detailed analysis. Since its discovery in 1925, the meteoritic origin of the iron dagger blade from the sarcophagus of the ancient Egyptian King Tutankhamun (14th C. BCE) has been the subject of debate and previous analyses yielded controversial results. We show that the composition of the blade (Fe plus 10.8 wt% Ni and 0.58 wt% Co), accurately determined through portable x-ray fluorescence spectrometry, strongly supports its meteoritic origin. In agreement with recent results of metallographic analysis of ancient iron artifacts from Gerzeh, our study confirms that ancient Egyptians attributed great value to meteoritic iron for the production of precious objects. Moreover, the high manufacturing quality of Tutankhamun's dagger blade, in comparison with other simple-shaped meteoritic iron artifacts, suggests a significant mastery of ironworking in Tutankhamun's time