Comparison of outcomes of acute kidney injury in elderly and non-elderly hospitalized patients in a tertiary care hospital in India: a prospective observational study

Background: The prevalence of acute kidney injury (AKI) progressively increases with age. A higher rate of dialysis dependency and mortality is observed in elderly with AKI. Here we have studied the comparison of clinical features, outcomes of AKI between elderly (age ³60 years) and non-elderly AKI patients and their risk factors for mortality. Methods: This prospective observational study enrolled 100 patients with AKI, with elderly and non-elderly in a 1:1 ratio for comparison, from September 2021 to January 2023 at AIIMS Rishikesh in India. Detailed history, clinical examination, relevant laboratory and radiological investigations were done to evaluate for the cause of AKI. Etiological causes, complications of AKI, and in-hospital outcomes were observed. They were given standard treatment and dialysis as per standard indications. We analysed the mortality risk of these groups using the Cox proportional hazards model. Results: The in-hospital mortality rates among these two groups were non-significant (p=0.29). A significantly higher number of patients with non-elderly AKI were HD-dependent at discharge (p=0.027). Elderly patients had significantly lesser complications like uremic encephalopathy and fluid overload compared to non-elderly. There was a significant association between mortality and female gender, intensive care unit (ICU) admissions, hospital-acquired AKI, pre-renal/renal causes, chronic obstructive pulmonary disease (COPD) as comorbidity, multiple organ dysfunction syndrome (MODS), mechanical ventilation requirement, vasopressor support requirement, need for hemodialysis and prolonged ICU stay. Conclusions: Elderly patients with AKI do not experience worse mortality outcomes than non-elderly patients with AKI. Therefore, elderly patients should not be denied timely treatment, solely based on their age

Mill Scale Corrosion and Prevention in Carbon Steel Heat Exchanger

The cause of material degradation of an ASTM A-124 grade carbon steel tube belonging to a heat exchanger has been investigated. Visual examination, followed by an in-depth microstructural characterization using optical microscopy, energy dispersive X-ray, and scanning electron microscopy, was carried out for understanding the primary cause of material degradation. Based on the results of an extensive examination as well as the background information provided on the heat exchanger, it was determined that the steel tubes were predominantly damaged by the mechanism of crevice corrosion facilitated by the presence of mill scale. It is concluded that the heat exchanger tubes were not properly investigated for defects after their fabrication. Based on the situation, the proper cleaning method was selected for preventing further corrosion in the system. A chemical cleaning process was designed using acid pickling along with an inhibitor and a surfactant

Pitting corrosion failure of an AISI stainless steel pointer rod

In this study, failure analysis of a thermostatic mixing valve pointer rod made of AISI 304 stainless steel was performed. Visual examination, followed by an in-depth microstructural characterization using optical and scanning electron microscopy, was carried out for understanding the primary cause of failure. Energy dispersive X-ray, X-ray diffraction analysis and transmission electron microscopic analyses were also necessary supplements to this investigation. Finally, the obtained results infer that the combined effect of large amounts of MnS inclusions and the presence of deformation induced martensite adversely affected the pitting corrosion resistance of the pointer rod material. It is concluded that the pointer rod material was not properly investigated for defects prior to and after its fabrication

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A rare case of primary amenorrhea

Crytomenorrhea arises usually due to the imperforate hymen, sometimes due to vaginal septum, rarely due to cervical agenesis. Here, we present a case of primary amenorrhea resulting from cervical agenesis in a 38-year-old woman. She presented with primary amenorrhea and cyclic lower abdominal pain. She had undergone some surgery 5 years back, details of which were not available. On examination secondary sexual characters were normal, per abdomen there was an 18 weeks size firm abdominopelvic mass. Local vaginal examination showed a blind vaginal pouch. A clinical diagnosis of hematometra due to transverse vaginal septum was made. However, magnetic resonance imaging pelvis suggested hematometra with cervical stenosis. The patient was taken up for examination under anaesthesia (EUA) and exploratory laparotomy. On opening the abdomen uterus found to be enlarged with dense adhesions all around and signs of endometriosis. Extensive adhesiolysis revealed bilateral chocolate cysts of ovaries with hematosalpinges and peritubal adhesions. Hysterotomy and drainage of tarry contents were followed by an exploration of the uterine cavity. The lower pole ended blindly with no evidence of any cervix. Peroperative diagnosis of cervical agenesis leading to hematometra and endometriosis was made. A subtotal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination confirmed ovarian endometriosis and adenomyosis of uterus. Though reconstructive surgery for cervical dysgenesis has been successful in some cases, hysterectomy is generally recommended for cervical agenesis

Effectiveness of various suspension media for electrophoretic deposition of YBCO superconductor powder

The stability of Y1Ba2Cu3O7-delta (YBCO) suspensions in various primary aliphatic alcohols (C1-C4) and in acetone has been studied by measurement of sedimentation density, electrophoretic mobility and specific conductivity. Maximum stability is observed for the suspension containing n-butanol as the dispersion medium. However, for the formation of a dense and adherent coating of YBCO on a silver substrate by electrophoretic deposition, the presence of an additive such as trichloroethylene is necessary. The best results are obtained when the trichloroethylene content of the medium is around 30 vol.%, for which the stability of the suspension is also found to be at its maximum. A mechanism for charge accumulation on the surface of YBCO particles in these suspensions has also been suggested

Solid oxide fuel cell materials: a review

Solid Oxide Fuel Cell (SOFC) is a solid-state electrochemical device that converts the chemical energy of a fuel directly into electrical energy. Due to its multi-fold inherent advantages SOFC is projected as the power source for the future generation. All over the world, extensive research activities are being pursued for the past decade and accordingly an immense wealth of literature is available in this field of research. Though this field of research activity is very wide and multidisciplinary, this review is mainly directed towards the processing, properties and fabrication of the state of the art ceramic materials, viz., yttria stabilized zirconia (YSZ) as the electrolyte material, Sr-doped LaMnO3 as the cathode material, Ni-YSZ cermet as the anode material and Ca-doped LaCrO3 as the interconnect material, that are being considered for the development of present day SOFC power modules. Special attention is given to the development of planar SOFC components fabrication taking into consideration the advantages of the planar design compared to the tubular design. A brief account of the future research and development direction is also discussed with an emphasis to widen the scope of materials research in the area of solid oxide fuel cells

Processing microstructure property correlation of porous Ni-YSZ cermets anode for SOFC application

The present paper investigates microstructural properties and electrical conductivity of cermets prepared by a solid-state technique, a liquid-dispersion technique and a novel electroless coating technique. The Ni-YSZ processed through different techniques shows varying temperature- conductivity behaviour. The cermets synthesized by electroless coating were found to be electronically conducting with 20 volume % Nickel, which is substantially lower than that normally reported. The conductivity of Ni-YSZ cermets was found highest for the samples prepared by an electroless coating technique and lowest for the samples prepared by a solid-state technique, the samples prepared from liquid-dispersion show an intermediate value for a constant nickel content. The variation in electrical conductivity has been well explained from the microstructure of the samples

Electrical behavior of nickel coated YSZ cermet prepared by electroless coating technique

Nickel–yttria stabilized zirconia (Ni/YSZ) cermet has been prepared by coating YSZ particles with metallic nickel using electroless coating technique. Concentration of nickel was varied between 7.23 and 64.99 wt%. Bulk samples were prepared using these nickel coated YSZ powders by uniaxial pressing followed by sintering in the temperature range 1200–1350 ◦C with a soaking time of 2–6 h. A thorough investigation on the electrical characteristics of the samples has been performed and an attempt has been made to study the effect of starting YSZ particle size, matrix density on the temperature dependence of conductivity of the cermet. Samples prepared by this technique shows metallic conductivity at a Ni concentration as low as 27.04 wt%. A detailed microstructural investigation of the samples is also reported