Pediatric urolithiasis: What role does metabolic evaluation has to play?

Background Pediatric urolithiasis is a perplexing problem faced by pediatricians as well as urologists across the globe. By early diagnosis and treatment of these risk factors, future stone formation may be prevented. Aim: To evaluate the clinical, biochemical and metabolic characteristics of the patients and the interventions required to prevent recurrence.Methods: In this retrospective study, cohort of pediatric patients presenting with urolithiasis at Kasturba Medical College, Manipal formed the study population. Patient’s records served as study tools. Medical records department was approached and data was collected. Metabolic evaluation was done in all children. Urine tests included urinalysis, urine culture, 24 hours urinary pH, volume, calcium, oxalate, citrate, uric acid, and creatinine. Finally a total of 58 pediatric urolithiasis cases were included in this study.Results: Mean age of study subjects was 6.85±1.27 years. Top three presentations of pediatric urolithiasis were symptoms of Urinary tract infection (UTI), abdominal pain and flank pain in 29.3%, 24.1% and 17.2% children respectively. Gross hematuria was observed in 15.5% of cases. 82.6% of stones were renal stones. Calcium oxalate stone was most common (50%) variety found. Hyperoxaluria was the most common (79.3%) metabolic abnormality detected. 31% had stone recurrence during follow up and 8 of these had >1 metabolic abnormality. Only 6/28 (21.4%) patients managed conservatively had stone recurrence whereas 12/30 (40%) managed with a procedure had stone recurrence.Conclusions: Metabolic evaluation for urolithiasis helps us to identify children those at increased risk for recurrent stone disease. Thus metabolic evaluation is a must in all pediatric patients as it helps in segregating patients needing medical therapy.

Experimental and probabilistic model validation of ultrasonic MEMS transceiver for blood glucose sensing

In contrast to traditional laboratory glucose monitoring, recent developments have focused on blood glucose self-monitoring and providing patients with a self-monitoring device. This paper proposes a system based on ultrasound principles for quantifying glucose levels in blood by conducting an in-vitro experiment with goat blood before human blood. The ultrasonic transceiver is powered by a frequency generator that operates at 40 kHz and 1.6 V, and variations in glucose level affect the ultrasonic transceiver readings. The RVM probabilistic model is used to determine the variation in glucose levels in a blood sample. Blood glucose levels are measured simultaneously using a commercial glucose metre for confirmation. The experimental data values proposed are highly correlated with commercial glucose metre readings. The proposed ultrasonic MEMS-based blood glucometer measures a glucose level of 257 ± 21 mg/dl. In the near future, the miniature version of the experimental model may be useful to human society

Performance Comparison of Si and GaAs Solar Cell due to Deposition of ZnO and SiO2 Antireflection Coating Layer

Received: 15 November 2023. Revised: 20 December 2023. Accepted: 15 January 2024. Available online: 31 March 2024.This article provides a new approach to the comparison of the performance of low-cost, efficient, and stable silicon and gallium arsenide solar cells. The design convention becomes challenging due to the absorption and current mismatching of the used antireflection coating layer with device sub-layers. The electrical properties of the proposed devices were analyzed in the presence of zinc oxide and silicon dioxide antireflection coating (ARC) layer, by adopting COMSOL 5.6 simulation software. These monolithically designed single junction solar cells of distinct materials with various band gaps and diverse spectral characteristics furnish the best efficiency with impressive degradation in reflection losses. The wideband antireflection layers are used to reduce reflection losses by reducing the refractive index towards the top surface of the photovoltaic cells. Simulation results provide the optimized values of the parameters of the devices within the range of 200-1200nm wavelength. At a thickness of 0.5μm zinc oxide, silicon solar cell and gallium arsenide solar cell provides efficiency of 16.85% and 10.69% respectively. Deposition of silicon dioxide on zinc oxide enhances the power efficiency to 16.89% and 10.7% respectively. A set of figures including maximum voltage, maximum current, conversion efficiency, short circuit current, and fill factor are presented. This article represents the use of zinc oxide and silicon dioxide antireflection layers with their optimum thickness can provide a better improvement in the device's performance

Comparative study between bone patellar tendon bone and quadrupled hamstring autografts in arthroscopic anterior cruciate ligament reconstruction with aperture fixation

Background: Bone patellar tendon bone (BPTB) and hamstring (HT) auto grafts have been used routinely in reconstruction of ACL over past two decades. Controversy still remains as to which graft is superior over other. Many studies have compared these graft options using different implants and different methods of fixation. Continuation of efforts in the same direction; purpose of the study is to compare these two graft options utilizing identical implants and similar method of fixation.Methods: 40 patients of clinically and radiologically diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft (n=20) and bone patellar tendon bone auto graft (n=20) utilizing bioscrew by aperture fixation method in both the groups. They were compared post operatively for symptomatic improvement, clinical and rolimeter laxity tests and Lysholm functional knee scoring at 02 year.Results: At the end of 02 years laxity measurement by rolimeter showed slightly better results in BPTB group; however it was not statistically significant (p value= 0.362). Knee pain at the end of 02 year was slightly more in HT groups (45%) as compared to BPTB group (35%) but not significant (p value =0.748). Instability symptoms are comparable in both the groups (sense of giving away on exertion). Manual laxity testing by Lachman and Pivot shift tests were comparable in both the groups with p value of 0.695 and 0.999 respectively. Lysholm functional knee score also showed no statistical significance (p value =0.957).Conclusions: There is no significant difference between HT and BPTB auto grafts in terms of clinical and functional outcome at the end of 02 years.

Experimental and probabilistic model validation of ultrasonic MEMS transceiver for blood glucose sensing

In contrast to traditional laboratory glucose monitoring, recent developments have focused on blood glucose self-monitoring and providing patients with a self-monitoring device. This paper proposes a system based on ultrasound principles for quantifying glucose levels in blood by conducting an in-vitro experiment with goat blood before human blood. The ultrasonic transceiver is powered by a frequency generator that operates at 40 kHz and 1.6 V, and variations in glucose level affect the ultrasonic transceiver readings. The RVM probabilistic model is used to determine the variation in glucose levels in a blood sample. Blood glucose levels are measured simultaneously using a commercial glucose metre for confirmation. The experimental data values proposed are highly correlated with commercial glucose metre readings. The proposed ultrasonic MEMS-based blood glucometer measures a glucose level of 257±21 mg/dl. In the near future, the miniature version of the experimental model may be useful to human society

Treatment with clobetasol propionate 0.025% topical therapy in various dermatoses

Owing to their anti-inflammatory and vasoconstrictive properties. Topical corticosteroids (TCs) provide benefits in various dermatological conditions, including atopic eczema, psoriasis, chronic hand eczema, and localized vitiligo. Clobetasol propionate (CP) is the most common topical agent possessing anti-inflammatory, antimitotic, antipruritic, and immunosuppressive properties that are employed in the management of plaque psoriasis. CP 0.025% cream was approved by the United States food and drug administration for the treatment of moderate-to-severe psoriasis in adult patients. The formulation is free from known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers, and has demonstrated hypoallergenic effects. High penetration of active ingredients and a lower degree of systemic absorption make CP 0.025% an effective and safe agent. This case series discusses the clinical experience of using CP 0.025% cream in various dermatologic conditions, focusing on its efficacy and safety

Structural, morphological, optical and electrical characterization of gahnite ferroan nano composite derived from fly ash silica and ZnO Mixture

The synthesis of a high value-added product, gahnite ferroan nano composite, from a mixture of fly ash silica and ZnO is a low-cost and non-expensive technique. The XRD pattern clearly reveals the synthesized product from fly ash after leaching is a product of high-purity gahnite ferroan composite. The grains are mostly cubical in shape. The optical band gap of powdered gahnite ferroan nano composite is 3.37 eV, which acts as a UV protector. However, the bulk sample shows that the 500 to 700 nm wavelength of visible light is absorbed, and UV light is allowed to pass through. So, the bulk sample acts as a band pass filter of UV light which can be used in many optical applications for conducting UV-irradiation activity. Dielectric permittivity and dielectric loss increase with a rise in temperature. The increase in the ac conductivity at higher temperatures denotes the negative temperature coefficient resistance (NTCR) behavior of the material

Application of virtual reality, augmented reality, and mixed reality in endourology and urolithiasis: An update by YAU endourology and Urolithiasis Working Group

The integration of virtual reality (VR), augmented reality (AR), and mixed reality (MR) in urological practices and medical education has led to modern training systems that are cost-effective and with an increased expectation toward surgical performance and outcomes. VR aids the user in interacting with the virtual environment realistically by providing a three-dimensional (3D) view of the structures inside the body with high-level precision. AR enhances the real environment around users by integrating experience with virtual information over physical models and objects, which in turn has improved understanding of physiological mechanisms and anatomical structures. MR is an immersive technology that provides virtual content to interact with real elements. The field of urolithiasis has adapted the technological advancements, newer instruments, and methods to perform endourologic treatment procedures. This mini-review discusses the applications of Virtual Reality, Augmented Reality, and Mixed Reality in endourology and urolithiasis.publishedVersio

Highly time-resolved chemical speciation and source apportionment of organic aerosol components in Delhi, India, using extractive electrospray ionization mass spectrometry

In recent years, the Indian capital city of Delhi has been impacted by very high levels of air pollution, especially during winter. Comprehensive knowledge of the composition and sources of the organic aerosol (OA), which constitutes a substantial fraction of total particulate mass (PM) in Delhi, is central to formulating effective public health policies. Previous source apportionment studies in Delhi identified key sources of primary OA (POA) and showed that secondary OA (SOA) played a major role but were unable to resolve specific SOA sources. We address the latter through the first field deployment of an extractive electrospray ionization time-of-flight mass spectrometer (EESI-TOF) in Delhi, together with a high-resolution aerosol mass spectrometer (AMS). Measurements were conducted during the winter of 2018/19, and positive matrix factorization (PMF) was used separately on AMS and EESI-TOF datasets to apportion the sources of OA. AMS PMF analysis yielded three primary and two secondary factors which were attributed to hydrocarbon-like OA (HOA), biomass burning OA (BBOA-1 and BBOA-2), more oxidized oxygenated OA (MO-OOA), and less oxidized oxygenated OA (LO-OOA). On average, 40 % of the total OA mass was apportioned to the secondary factors. The SOA contribution to total OA mass varied greatly between the daytime (76.8 %, 10:00–16:00 local time (LT)) and nighttime (31.0 %, 21:00–04:00 LT). The higher chemical resolution of EESI-TOF data allowed identification of individual SOA sources. The EESI-TOF PMF analysis in total yielded six factors, two of which were primary factors (primary biomass burning and cooking-related OA). The remaining four factors were predominantly of secondary origin: aromatic SOA, biogenic SOA, aged biomass burning SOA, and mixed urban SOA. Due to the uncertainties in the EESI-TOF ion sensitivities, mass concentrations of EESI-TOF SOA-dominated factors were related to the total AMS SOA (i.e. MO-OOA + LO-OOA) by multiple linear regression (MLR). Aromatic SOA was the major SOA component during the daytime, with a 55.2 % contribution to total SOA mass (42.4 % contribution to total OA). Its contribution to total SOA, however, decreased to 25.4 % (7.9 % of total OA) during the nighttime. This factor was attributed to the oxidation of light aromatic compounds emitted mostly from traffic. Biogenic SOA accounted for 18.4 % of total SOA mass (14.2 % of total OA) during the daytime and 36.1 % of total SOA mass (11.2 % of total OA) during the nighttime. Aged biomass burning and mixed urban SOA accounted for 15.2 % and 11.0 % of total SOA mass (11.7 % and 8.5 % of total OA mass), respectively, during the daytime and 15.4 % and 22.9 % of total SOA mass (4.8 % and 7.1 % of total OA mass), respectively, during the nighttime. A simple dilution–partitioning model was applied on all EESI-TOF factors to estimate the fraction of observed daytime concentrations resulting from local photochemical production (SOA) or emissions (POA). Aromatic SOA, aged biomass burning, and mixed urban SOA were all found to be dominated by local photochemical production, likely from the oxidation of locally emitted volatile organic compounds (VOCs). In contrast, biogenic SOA was related to the oxidation of diffuse regional emissions of isoprene and monoterpenes. The findings of this study show that in Delhi, the nighttime high concentrations are caused by POA emissions led by traffic and biomass burning and the daytime OA is dominated by SOA, with aromatic SOA accounting for the largest fraction. Because aromatic SOA is possibly more toxic than biogenic SOA and primary OA, its dominance during the daytime suggests an increased OA toxicity and health-related consequences for the general public.</p