Recurrent Painless Haematuria in a Well Child—A Case Report

\ua9 Association of Surgeons of India 2024.We report a case of appendico-vesical fistula (AVF) in a 12-year-old boy presenting with a 2-month history of solely recurrent painless macroscopic haematuria. Ultrasound and MRI scans were suggestive of an urachus remnant with a calculus in the bladder dome. Cystoscopy showed a bladder diverticulum with mucosal inflammation. Open laparotomy eventually revealed the AVF, as a complication of a clinically ‘silent’ acute appendicitis. AVF is a rare complication of acute appendicitis. A literature review identified 17 further paediatric cases. Whilst faecaluria and pneumaturia are pathognomonic for AVF, these were present in only 24% of patients. Most patients presented with recurrent urinary tract infections or urinary symptoms, and most had a history of abdominal pain and vomiting. Imaging studies and cystoscopy were often inconclusive, and most diagnoses were made at surgery. A high index of clinical suspicion helps to guide diagnosis and treatment

Extractive Spectrophotometric Determination of Omeprazole in Pharmaceutical Preparations

Purpose: To develop a simple, rapid and selective method for the extractive spectrophotometric determination of omeprazole using acidic dyes. Methods: Extractive spectrophotometric determination of omeprazole was developed using acidic dyes - bromophenol blue and orange G - as ion-pairing agents in aqueous medium (pH 7.0 and 6.0, respectively). The ion pair chromogen formed, which was extracted with chloroform, was measured quantitatively at 408 nm and 508 nm, respectively. The developed method was used to analyse commercial omeprazole tablets.Results: Using bromophenol blue and orange G dyes, the ion-paired formed obeyed Beer’s law in the ranges 5 - 30 μg/ml and 50 - 250 μg/ml at 408nm and 503nm, respectively, with molar absorptivities of1.712 × 103 L mol-1 cm-1 and 2.095 × 103 L mol-1 cm-1, respectively, for omeprazole,. The purity of omeprazole obtained was 98.1±0.9 and 99.7±0.3, respectively. Standard deviation (S.D.), % relativestandard deviation (% R.S.D.) and standard error were 0.001 - 0.013, 0.94 - 1.07 % and 4 × 10-4, respectively. The complexes formed were stable for approx. 3 h. Conclusion: Recovery studies gave satisfactory results indicating that none of the major additives/excipients interferred with the assay method. Therefore, a simple, rapid and selective methodwas developed for extractive spectrophotometric determination of omeprazole. This method may be useful for routine laboratory analysis of omeprazole

EVALUATION OF BIOLOGICAL ACTIVITIES OF NANOCRYSTALLINE TETRAGONAL ZIRCONIA SYNTHESIZED VIA SOL-GEL METHOD

Objective: The objective of the following study was a synthesis of nanocrystalline tetragonal zirconia (ZrO2) using simple sol–gel method and evaluation of its structural and biological properties.Methods: The sample was characterized by X-ray powder diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy (TEM) and evaluated for cell growth study using 3T3 mouse fibroblast cells and for degradation using Phosphate Buffered Saline (PBS) solution. The synthesized materials were also evaluated for their antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacterial strains.Results: The XRD pattern shows that the tetragonal phase of nanocrystalline zirconia was obtained at relatively low temperature i.e. 300 °C. The FESEM images showed that the prepared sample consists of particles in the range of 35-69 nm and homogenous particle size distribution. The TEM images confirmed the results shown by FESEM images. The sample of zirconia has excellent tissue biocompatibility, higher cell growth and does not show the toxicity towards normal 3T3 mouse fibroblast cells. The result of qualitative antibacterial tests revealed that the nanocrystalline zirconia had an important inhibitory activity on E. coli and S. aureus. The sample shows stability at the physiological condition and does not show degradation.Conclusion: Nanocrystalline tetragonal zirconia shows higher cell growth and efficient antibacterial activity against E. coli and S. aureus bacterial pathogen and also it is stable at the physiological condition. Hence, it can be used for various biomedical applications.Keywords: Nanocrystalline zirconia, Sol-gel route, Antimicrobial action, Biomedical applicatio

A novel reformulation of the Theory of Critical Distances to design notched metals against dynamic loading

In the present study the linear-elastic Theory of Critical Distances (TCD) is reformulated to make it suitable for predicting the strength of notched metallic materials subjected to dynamic loading. The accuracy and reliability of the proposed reformulation of the TCD was checked against a number of experimental results generated by testing, under different loading/strain rates, notched cylindrical samples of aluminium alloy 6063-T5, titanium alloy Ti–6Al–4V, aluminium alloy AlMg6, and an AlMn alloy. To further validate the proposed design method also different data sets taken from the literature were considered. Such an extensive validation exercise allowed us to prove that the proposed reformulation of the TCD is successful in predicting the dynamic strength of notched metallic materials, this approach proving to be capable of estimates falling within an error interval of ±20%. Such a high level of accuracy is certainly remarkable, especially in light of the fact that it was reached without the need for explicitly modelling the stress vs. strain dynamic behaviour of the investigated ductile metals

CRUSE®-An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria

Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE ®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need. Methods: CRUSE ® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE ® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE ® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. Results: CRUSE ® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. Conclusions: The initial data from CRUSE ® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.</p

CRUSE®-An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria

Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE ®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need. Methods: CRUSE ® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE ® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE ® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. Results: CRUSE ® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. Conclusions: The initial data from CRUSE ® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.</p

The global impact of the COVID-19 pandemic on the management and course of chronic urticaria

Introduction: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and Methods: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation

A concept for integrated care pathways for atopic dermatitis—A GA2LEN ADCARE initiative

Introduction: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. Methods: The GA2LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2EN ADCARE centres. Results: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. Conclusion: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD

A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative

INTRODUCTION: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. METHODS: The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres. RESULTS: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. CONCLUSION: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD