Outcomes of reconstructive surgery of tuberculosis affecting the ureter and bladder

Background: Genito-urinary tuberculosis (GUTB) affects kidneys and bladder more frequently leading to scarring and eventually loss of function. Reconstructive surgical procedures are implemented to preserve the function by relieving obstruction of the urinary tract. The main objective of this study was to evaluate the outcome of urinary reconstructive surgical procedures in terms of improvement in renal function and quality of life.Methods: This was retrospective analysis of all patients treated for tuberculous stricture of the ureter and scarring of the bladder from January 2001 to December 2005. Outcome of interventions were assessed using IVU, TC-DTPA renogram and serum creatinine level.Results: Among the 160 genito-urinary tuberculosis cases diagnosed in the 5 year period, only 51 patients fulfilled the inclusion criteria and were managed with reconstructive surgery alone or in combination with temporary diversion. Sixteen (31.5%) patients had elevated serum creatinine level greater than 1.5mg% out of which Nadir serum creatinine level less than 1.5mg% was found in only 9 patients following various procedures. Pan urethral or multiple segment involvement occurred in 24 ureters of which 10 required eventual definitive reconstructive surgery. Twenty eight bladders were found scarred of which 17 needed augmentation procedures.Conclusions: Based on acceptable renal function using Tc-scan, renogram and other functional assessments an overall favourable outcome of 92% at median follow up of 18 (6-48) months was observed

Outcomes of Reconstructive Surgery of Tuberculosis Affecting the Ureter and Bladder

Background : Genito-urinary tuberculosis (GUTB) affects kidneys and bladder more frequently leading to scarring and eventually loss of function. Reconstructive surgical procedures are implemented to preserve the function by relieving obstruction of the urinary tract. The main objective of this study was to evaluate the outcome of urinary reconstructive surgical procedures in terms of improvement in renal function and quality of life. Methods :This was retrospective analysis of all patients treated for tuberculous stricture of the ureter and scarring of the bladder from January 2001 to December 2005. Outcome of interventions were assessed using IVU, TC-DTPA renogram and serum creatinine level. Results : Among the 160 genito-urinary tuberculosis cases diagnosed in the 5 year period, only 51 patients fulfilled the inclusion criteria and were managed with reconstructive surgery alone or in combination with temporary diversion. Sixteen (31.5%) patients had elevated serum creatinine level greater than 1.5mg% out of which Nadir serum creatinine level less than 1.5mg% was found in only 9 patients following various procedures. Pan urethral or multiple segment involvement occurred in 24 ureters of which 10 required eventual definitive reconstructive surgery. Twenty eight bladders were found scarred of which 17 needed augmentation procedures. Conclusion : Based on acceptable renal function using Tc-scan, renogram and other functional assessments an overall favourable outcome of 92% at median follow up of 18 (6-48) months was observed

Sensitive product feature integrity and confidentiality using blockchain-based internet of things (IoT) architecture

Small-scale third-party accessories vendors face numerous challenges such as (i) warranty period covered for sensitive product, (ii) malicious induction, and (iii) extract root cause of product failure after customer experienced in the real time usage. Therefore, an advanced industrial environment is necessary to resolve these limitations. It offers strong security levels as well as intelligent root cause detection over failure. In this work, propose a blockchain-based internet of things (IoT) architecture for industry 4.0, which includes a voting decision mechanism for IoT device authentication and fault classification based on device and product trust values, respectively. These values are regularly updated in the historical trust value and machinery database for every successful product transaction and identify a new failure cause to set feature for next iteration set from the defective industrial cloud database. The analytical model and simulation results for correct authentication ensure that the proposed architecture achieves 86% eligibility of accuracy across a high ratio of malicious attacks in less converged time