Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

Background: Percutaneous Nephrostomy or Ureteric Stenting is indicated in patients with Acute Renal Failure following urinary tract obstruction. The purpose of this study was to evaluate the better treatment modality in terms of S. Creatinine level.  Methods: Total 50 patients with Creatinine level of >2 mg/dl and hydronephrosis due to upper urinary tract obstruction were grouped into either percutaneous nephrostomy or stent insertion groups. These patients were then evaluated by overall trend of S. creatinine and urine output levels postoperatively.Results: Two comparable groups of PCN and DJS were formed with a mean age of 45.5 years and 47.9 years. Male to female ratio was 1.5:1 and 1.2:1 respectively. Pain with oliguria or anuria was the major presentation. The urine output levels showed a sudden increase postoperatively with a subsequent trend towards normal value in both the groups. Creatinine however showed a normalizing trend from a mean 6.46 mg/dl preoperatively to 1.01mg/dl postoperatively in PCN group whereas in DJS group 5.38mg/dl preoperatively to 2.75mg/dl with a rising trend from POD 15 requiring conversion to PCN in 20% of patients with subsequent normalization of creatinine levels to 0.95 mg/dl. Statistically we found no difference in the outcome when both the groups were compared in view of serum creatinine and urine output levels whereas there is a significant difference in the pre and post operative outcome of both the groups.  Conclusions: Our results thus support that though there is no significant difference among both the procedures, ureteral stents are associated with intolerable lower urinary tract symptoms owing to conversion to secondary percutaneous Nephrostomy. Hence percutaneous nephrostomy is superior to ureteral stents for diversion of urine in patients with ARF due to obstructive uropathy.

A model for rotorcraft flying qualities studies

This paper outlines the development of a mathematical model that is expected to be useful for rotorcraft flying qualities research. A computer model is presented that can be applied to a range of different rotorcraft configurations. The algorithm computes vehicle trim and a linear state-space model of the aircraft. The trim algorithm uses non linear optimization theory to solve the nonlinear algebraic trim equations. The linear aircraft equations consist of an airframe model and a flight control system dynamic model. The airframe model includes coupled rotor and fuselage rigid body dynamics and aerodynamics. The aerodynamic model for the rotors utilizes blade element theory and a three state dynamic inflow model. Aerodynamics of the fuselage and fuselage empennages are included. The linear state-space description for the flight control system is developed using standard block diagram data

Effect of Al2O3 Reinforcement and Al2O3–13 wt% TiO2 Bond Coat on Plasma Sprayed Hydroxyapatite Coating

In present work an attempt has been made to enhance mechanical properties of plasma sprayed hydroxyapatite coating by addition of 10 wt% aluminum oxide. A bond coat of Al2O3-13TiO2 has been  applied to improve strength of hydroxyapatite composite coating. Mechanical properties of coatings with addition of alumina and with incorporation of bond coat have been investigated in accordance with the ASTM C 633-79. Results indicate that the tensile bond strength of hydroxyapatite coating increased by 13 per cent by alumina reinforcement and 25 per cent by both reinforcement and application of bond layer respectively. The area of adhesive failure was found to decrease for hydroxyapatite-alumina composite coating and hydroxyapatite composite coating with bond coat as compared to pure hydroxyapatite coating. The microharness of specimens was found to increase with reinforcement, however the highest hardness was recorded for bond coat. The microhardness was found to decrease with distance from substrate coating interface.Defence Science Journal, 2012, 62(1), pp.193-198, DOI:http://dx.doi.org/10.14429/dsj.62.103

Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases

Objective. To describe the clinical characteristics and radiological findings in two patients with subacute encephalitis associated with elevated serum voltage-gated potassium channel antibody (VGKCAb) and antithyroperoxidase (TPO) antibody. Case Reports. Case 1: 63-year-old woman was admitted for altered mental status and possible seizure activity. MRI brain showed hyperintensity in the bilateral hippocampal areas. She was positive for VGKCAb and anti-TPO antibodies. She was treated with steroids, IVIG, plasma exchange and azathioprine. After 8 months, she had marked improvement in her memory and seizures. Case 2: 61-year-old woman was admitted for video EEG monitoring of unclassified seizure and cognitive function decline. MRI of the brain showed mild hyperintensity in bilateral hippocampal areas and significant atrophy in the frontotemporal lesion. Anti-TPO antibody and VGKCAb were positive. She was treated with steroids, plasma exchange and azathioprine. After 9 months, she had marked improvement in her memory and seizures. Conclusion. Autoimmune subacute encephalitis appears to be an underdiagnosed entity. It is important to screen patients with subacute encephalitis for anti-TPO antibody and VGKCAb, particularly in the presence of seizures. Immunosuppressive therapy appears to be effective in treating this entity

Methadone-Induced Delayed Posthypoxic Encephalopathy: Clinical, Radiological, and Pathological Findings

Objective. To describe the clinical, radiological and pathological findings in a patient with methadone-induced delayed posthypoxic encephalopathy (DPHE). Case Report. A Thirty-eight-year-old man was found unconscious for an unknown duration after methadone and diazepam ingestion. His initial vitals were temperature 104 degree Fahrenheit, heart rate 148/minute, respiratory rate 50/minute, and blood pressure 107/72 mmhg. He developed renal failure, rhabdomyolysis, and elevated liver enzymes which resolved completely in 6 days. After 2 weeks from discharge he had progressive deterioration of his cognitive, behavioral and neurological function. Brain MRI showed diffuse abnormal T2 signal in the corona radiata, centrum semiovale, and subcortical white matter throughout all lobes. Extensive work up was negative for any metabolic, infectious or autoimmune disorder. Brain biopsy showed significant axonal injury in the white matter. He was treated successfully with combination of steroids and antioxidants. Follow up at 2 year showed no residual deficits. Conclusion. Our observation suggests that patients on methadone therapy should be monitored for any neurological or psychiatric symptoms, and in suspected cases MRI brain may help to make the diagnosis of DPHE. A trial of steroids and antioxidants may be considered in these patients

Microbial metabolites in nutrition, healthcare and agriculture

Microorganisms are a promising source of an enormous number of natural products, which have made significant contribution to almost each sphere of human, plant and veterinary life. Natural compounds obtained from microorganisms have proved their value in nutrition, agriculture and healthcare. Primary metabolites, such as amino acids, enzymes, vitamins, organic acids and alcohol are used as nutritional supplements as well as in the production of industrial commodities through biotransformation. Whereas, secondary metabolites are organic compounds that are largely obtained by extraction from plants or tissues. They are primarily used in the biopharmaceutical industry due to their capability to reduce infectious diseases in human beings and animals and thus increase the life expectancy. Additionally, microorganisms and their products inevitably play a significant role in sustainable agriculture development

Evaluation of spectrum of MRI findings in children with Hypoxic Ischemic Encephalopathy and its comparison with transcranial sonography

Background: Hypoxic ischemic encephalopathy is a serious concern among asphyxiated newborns due to the associated long term sequelae like cognitive impairment and cerebral palsy. Though the incidence of hypoxic injury remains higher in preterm babies due to incomplete brain maturation, it can occur in term babies as well despite institutional deliveries due to an array of unavoidable fetal, maternal and placental causes. Aims: This study was conducted as an attempt to evaluate the risk factors, to study the correlation between the term of pregnancy with TCUS and MRI imaging findings in HIE and characterise patterns of CNS involvement. Materials and methods: It was a cross-sectional study carried on 50 neonates with clinically diagnosed HIE presenting to the Department of Radiodiagnosis, Rajindra Hospital Patiala who were subjected to transcranial sonography and MRI. Results and Conclusion: This study demonstrated term infants have significant involvement of basal ganglia thalamus type (central) pattern of involvement and preterm infants have periventricular leukomalacia type (white matter injury) of a pattern of involvement. The overall sensitivity and specificity of TCUS in detecting imaging findings in children with clinically diagnosed HIE compared to MRI was found to be 70.45% and 50% respectively, yielding the overall diagnostic accuracy of TCUS as 68% compared to MRI. TCUS can depict central and white matter abnormalities better than peripheral lesions. However MRI provides additional diagnostic information in many cases and can detect precisely the extent of brain injury

Reaction of sulphate radical anion (SO<SUB>4</SUB><SUP>&#8226;-</SUP>) with hydroxy- and methyl-substituted pyrimidines: a pulse radiolysis study

Reactions of sulphate radical anion (SO4&#8226;-) with 4,6-dihydroxy-2-methyl pyrimidine (DHMP), 2,4-dimethyl-6-hydroxy pyrimidine (DMHP), 6-methyl uracil (MU) and 5,6-dimethyl uracil (DMU) have been studied by pulse radiolysis at pH 3 and at pH 10. The transient intermediate spectra were compared with those from the reaction of hydroxyl radical (&#8226;OH). It is proposed that SOSO4&#8226;- produces radical cations of these pyrimidines in the initial stage. These radical cations are short-lived except in the case of DMHP where a relatively longer lived radical cation is proposed to be formed. When there is a hydrogen atom attached to the N(1) or N(3) position, a deprotonation from these sites is highly favored. When there is no hydrogen attached to these sites, deprotonation from a substituted methyl group is favored. At acidic pH, deprotonation from nitrogen is observed for DHMP, MU and DMU. At basic pH, the radical cation reacts with OH- leading to the formation of OH adducts

Reaction of oxide radical ion (O<SUP>&#8226;-</SUP>) with substituted pyrimidines

Pulse radiolysis technique has been used to investigate the reaction of oxide radical ion (O&#8226;-) with 4,6-dihydroxy-2-methyl pyrimidine (DHMP), 2,4-dimethyl-6-hydroxy pyrimidine (DMHP), 5,6-dimethyl uracil (DMU) and 6-methyl uracil (MU) in strongly alkaline medium. The second-order rate constants for the reaction of O&#8226;- with these compounds are in the range 2-5 &#215; 108 dm3 mol-1 s-1. The transient absorption spectra obtained with DHMP have two maxima at 290 and 370 nm and with DMHP have maxima at 310 and 470 nm. The transient spectrum from DMU is characterized by its absorption maxima at 310 and 520 nm and that of MU by its single maximum at 425 nm. The intermediate species were found to react with N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD) with high G(TMPD&#8226;+) values ranged between 3.9 &#215; 10-7 molJ-1 and 4.8 &#215; 10-7 molJ-1. These radicals undergo decay by second-order kinetics (2k/&#949; = 1.0-1.7 &#215; 106 s-1). The reaction of O&#8226;- with the selected pyrimidines is proposed to proceed through a hydrogen abstraction from the methyl group forming allyl type radicals. These are mainly oxidizing radicals and hence readily undergo electron transfer reactions with TMPD