Optimizing the design of a dual function brake accelerator pedal

Call number: LD2668 .R4 1968 K34

Proximally migrated Double J stent in hydronephrotic kidneys: Etiological factors and management

Double J stents have become an essential tool in urologist’s armamentarium but are never without potential complications. Migration of DJ stent is a recognized complication, though its proximal migration into the upper ureter, pelvicalyceal system is reported rarely. This can add to the cost of patients and increases hospital stay if another general/ regional anesthesia session is required for its repositioning/removal. We successfully repositioned or removed proximally migrated DJ stents ureteroscopically under local anesthesia and analgesia in all of our case series patients on a daycare basis. We emphasize the importance of recordkeeping and follow up of stented patients particularly with those with hydronephrotic systems. In the event of proximal migration of the DJ stent, it can be successfully repositioned or removed under local anesthesia and analgesia. Keywords: Double J stent, proximal migration, ESWL-Extracorporeal shockwave lithotrips

Consortium of management practices in long-run improves soil fertility and carbon sequestration in drylands of semi-arid tropics

PRIFPRI3; ISI; 4 Transforming Agricultural and Rural Economies; DCANatural Resources and Resilience (NRR); Transformation Strategie

Penile Degloving injuries, a quagmire riddled out: A case series

Penile Degloving injuries are rare among all genitourinary injuries. These injuries occur as a result of road traffic accidents, animal injuries (bites), industrial injuries, etc. Penile skin avulsion occurs due to traction injury or trapping of the skin resulting in tear of skin from underlying tunica albuginea. Due to excellent blood supply early primary repair if done early and possible results in the best outcome. Patients with skin loss can be managed by flaps mobilization from remaining skin. In occasional cases when primary closure is not possible, split skin grafting is required. The timely repair results in minimal short-term complications and excellent long-term cosmetic results without scarring and normal erectile function. Whenever possible these injuries should be primarily closed, employing grafts and flaps when required even in delayed presentation and animal bites. We describe degloving injuries in case series of two patients with unalike aetiologies. These were managed by primary closure with degloved skin after mobilization and debridement of nonviable skin after adequate washing with normal saline. Despite minor wound complication like wound infection, flap necrosis, penile oedema, ultimately wound recovered within few days. On follow up patients were able to void normally in addition cosmetic and aesthetic outcomes were excellent. Furthermore, patients were able to achieve good erections with no curvature.  We concluded that penile skin if reposed early with good wound management results in excellent outcomes with minimal long-term scarring, voiding and erectile dysfunction

Gibbs energy of formation of CaCu3Ti4O12CaCu_3Ti_4O_{12} and phase relations in the system CaO−CuO/Cu2O−TiO2CaO-CuO/Cu_2O-TiO_2

The standard Gibbs energy of formation of CaCu3Ti4O12 (CCTO) from $CaTiO_3$, CuO and $TiO_2$ has been determined as a function of temperature from 925 to 1350 K using a solid-state electrochemical cell with yttria-stabilized zirconia as the solid electrolyte. Combining this result with information in the literature on $CaTiO_3$, the standard Gibbs energy of formation of CCTO from its component binary oxides, CaO, CuO and $TiO_2$ has been obtained: Delta G(f,ox)(o) $(CaCu_3Ti_4O_{12})/J mol^{-1}$ (+/- 600) = -125231 + 6.57 (T/K). The oxygen chemical potential corresponding to the reduction of CCTO to $CaTiO_3$, $TiO_2$ and $Cu_2O$ has been calculated from the electrochemical measurements as a function of temperature and compared on an Ellingham diagram with those for the reduction of CuO to $Cu_2O$ and $Cu_2O$ to Cu. The oxygen partial pressures corresponding to the reduction reactions at any chosen temperature can be read using the nomograms provided on either side of the diagram. The effect of the oxygen partial pressure on phase relations in the pseudo-ternary system $CaO-CuO/Cu_2O-TiO_2$ at 1273 K has been evaluated. The phase diagrams allow identification of secondary phases that may form during the synthesis of the CCTO under equilibrium conditions. The secondary phases may have a significant effect on the extrinsic component of the colossal dielectric response of CCTO

Gibbs energy of formation of CaCu3Ti4O12 and phase relations in the system CaO-CUO/CU2O-TiO2

he standard Gibbs energy of formation of CaCu3Ti4O12 (CCTO) from CaTiO3, CuO and TiO2 has been determined as a function of temperature from 925 to 1350 K using a solid-state electrochemical cell with yttria-stabilized zirconia as the solid electrolyte. Combining this result with information in the literature on CaTiO3, the standard Gibbs energy of formation of CCTO from its component binary oxides, CaO, CuO and TiO2, has been obtained: View the MathML source (CaCu3Ti4O12)/J mol−1 (±600) = −125231 + 6.57 (T/K). The oxygen chemical potential corresponding to the reduction of CCTO to CaTiO3, TiO2 and Cu2O has been calculated from the electrochemical measurements as a function of temperature and compared on an Ellingham diagram with those for the reduction of CuO to Cu2O and Cu2O to Cu. The oxygen partial pressures corresponding to the reduction reactions at any chosen temperature can be read using the nomograms provided on either side of the diagram. The effect of the oxygen partial pressure on phase relations in the pseudo-ternary system CaO–CuO/Cu2O–TiO2 at 1273 K has been evaluated. The phase diagrams allow identification of secondary phases that may form during the synthesis of the CCTO under equilibrium conditions. The secondary phases may have a significant effect on the extrinsic component of the colossal dielectric response of CCTO

Genitourinary tuberculosis: clinical profile, diagnostic approach and treatment outcome in a tertiary care center of North India

Introduction:Genitourinary tuberculosis (GUTB) is the second commonest form of extrapulmonary tuberculosis with more than 90% of cases occurring in developing countries and kidney being the most common site of involvement. We present clinico-epidemiological profile of patients and management of genitourinary tuberculosis in IGMC Shimla.Material and methods: We conducted cross sectional record-based study of patients diagnosed and treated for genitourinary tuberculosis in the Department of Urology, IGMC Shimla from January 2017 to November 2020.Results: Eighty-six patients were treated for GUTB and mean age of patients was 42.2 years (18-78 years). In clinical presentation, irritative voiding symptoms i.e., frequency and dysuria (80.23% and 46.51% respectively) were the most common, followed by flank pain and weight loss (40.69% each), further followed by low grade fever (34.88%) and hematuria (33.72%). All patients were started on ATT from DOTS center and then were transferred to local DOTS units of their respective districts. Three patients required modification of ATT due to significant side effects. One patient died as a result of complications related to ATT and comorbid illness.Ultrasound guided percutaneous nephrostomy (PCN), Double J stenting and pigtail drainage for psoas abscess was done in 24 (27.91%) patients, 22 (25.58%) patients and in 8 (9.3%) patients respectively. Reconstructive surgery was done in 25 patients i.e., ureteroureterostomy in 3 (3.48%) patients, ureteric reimplant in 14 patients (16.27%) patients ,augmentation ileocystoplasty in 4 (4.65%) patients, Boari flap in 4 (4.65%) patients. Nephrectomy was done in 3 (3.48%) patients and cystectomy with ileal conduit was done in 3 (3.48%) patients. Conclusion: GUTB is a prevalent disease in our country although data regarding GUTB is quite limited. GUTB complaints are mostly trivial and nonspecific but consequences are grave. Proper early diagnosis and timely management can prevent morbidity and potential mortality in these patients. Timely intervention and reconstructive surgery is required in a significant number of patients to preserve kidney, ureter, and urinary bladder function

Chronic Radiation cystitis: a review of medical and surgical management

Radiation cystitis is a complication of radiation treatment given for pelvic malignancies. Radiation cystitis can present as mild symptoms of dysuria, frequency, and hematuria to severe life-threatening complications like intractable hematuria, bladder perforation and contracted non-functional urinary bladder, fistula etc. Treatment is tailored according to the severity of symptoms and available treatment modalities sequentially. Initial treatment of hematuria is intravenous fluids, blood transfusions, cystoscopy and fulguration, irrigation with intravesical agents like alum, hyperbaric oxygen therapy, angioembolisation, urinary diversion and surgery (cystectomy). Radiation cystitis is associated with short- and long-term complications in pelvic malignancies patients. Early diagnosis, follow up, treatment is crucial for decreasing morbidity and mortality in these patients. In this review article we describe the current protocol in diagnosing and managing radiation cystitis. Keywords Pelvis, Radiation, Hematuria, intravesical treatments, Alum, formali

Soil management for Sustained and Higher Productivity in the Adarsha Watershed

Kothapally watershed is a typical representative of rain-fed (800 mm rainfall) semi-arid tropics (SAT) with varying soil depth in the watershed and widespread soil degradation as the major challenge coupled with low crop yields and family incomes. Before the onset of initiative during 1999, soil health mapping and baseline surveys showed varying soil depth in fields at different topo-sequence, macro-/micronutrient deficiencies along with low soil carbon (C) levels and heavy soil loss through erosion that compromised with crop production in the watershed. Inappropriate fertilizer management decisions leading to negative budget for primary nutrients in major crops/cropping systems highlighted suboptimal fertilizer use. Unawareness about micro-/secondary nutrient deficiencies like sulphur (S), boron (B) and zinc (Zn) and lack of addition of such fertilizers contributed to low crop yields and declining fertilizer and water use efficiency. Farmers participatory trials highlighted yield loss of 13–39% in crops like sorghum and maize in the absence of deficient micro-/secondary nutrient fertilizers. Recycling of on-farm wastes through vermicomposting and biomass generation using N-rich Gliricidia on farm boundaries were promoted for fertilizer savings and crop yield benefit alongside soil carbon building for developing resilience. The impact of integrated soil health management practices cumulatively observed over 13 years was demonstrated during 2012 soil health mapping that showed improved mean level of soil organic C; available nutrients, viz. phosphorus (P), B, Zn and S; and significantly reduced number of fields with low nutrient/C levels. Along with yield advantage, soil loss was significantly reduced from 3.48 t ha in untreated area to 1.62 t ha in treated watershed area