An Analysis of Post Surgical Outcome in Primary Vesico Ureteric Reflux Patients

7 INTRODUCTION: Vesico ureteral reflux is a dynamic event – the retrograde flow of bladder urine into the upper urinary tracts. It’s a feature of disordered anatomy and function at the uretero vesical junction. Although this reflux nephropathy may disappear during growth, it is of clinical concern because of the morbidity from ascending urinary infection and associated nephropathy that can lead to hypertension and renal function insufficiency. To reduce the morbidity and mortality associated with vesico ureteric reflux, there are many studies available all over the world with relation to the pre-op work up, medical and surgical management, post operative follow up and outcome. AIMS AND OBJECTIVES: 1. To analyse the post surgical outcome in primary vesicoureteral reflux patients with the clinical and imaging parameters in the follow up. 2. To analyse the primary vesico ureteral reflux treated surgically with those treated by chemoprophylaxis alone. MATERIALS AND METHODS: This a prospective study conducted in the department of pediatric surgery, Institute of Child health over a period of 2½ years. This study was performed between August 2009 and January 2012 for primary vesico ureteral reflux. Apart from the clinical examination, baseline investigation, blood parameters, ultrasonogram – voiding cystourethrogram intravenous urogram and DMSA scan were taken. Patients were followed up for and more year post operatively for resolution of reflux and urinary tract infection. Patients treated surgically were compared with those treated with chemoprophylaxis alone in terms of recurrent urinary tract infections and resolution of reflux as demonstrated by voiding cystourethrogram. SELECTION CRITERIA: Inclusion Criteria: All patients with primary vesico ureter reflux (i.e due to intrinsic defect within the ureterovesical junction) irrespective of grade or laterality. Exclusion Criteria: All patients with secondary vesico ureteral reflux as a result of another pathology like associated bladder outlet obstruction (posterior urethral valve) and neurogenic bladder dysfunction are excluded from the study. CONCLUSION: 1. Majority of cases presented at an age of <3 years and all were symptomatic with history of recurrent UTIs. 2. Male female ratio was 1:0.6, predominately males in our study. 3. Bilateral cases were 62.9% as compared to 37.1% unilateral cases. 4. Grade III, IV, V reflux constituted 83.9% of total renal units. 5. Type of surgery was predominantly Cohen’s Reimplant with success rate of 95.6%. 6. In ultrasonogram, an increase in diameter of the ureter and/or renal pelvis was observed as a sign of reflux. 7. Micturiting cystourethrogram is an investigation tool for grading the reflux pre operatively and for the detection of post operative resolution. 8. Surgery is the preferred option for persistent Gr.III & IV and all Gr.V reflux. 9. Many patients who eventually required surgical management had already suffered kidney damage. So, early referral for surgical intervention would reduce the number and extent of renal damage due to reflux

VALUE ADDITION OF ERI SILK YARNS WITH ALLAMANDA GRANDIFLORA - A NATURAL COLOURANT

Eri silk is one of the four varieties of silk mostly available in northeastern region of India. Recent trends in the world market of silk revealed that eri silk had tremendous potential as it was gifted with unique properties of protecting human body from some aliments as well as its use as fashionable dress and furnishing materials besides providing comfort of warmth. To suit the norms of the present national and international market, dyeing eri silk with natural dyes contributes to its value chain. The information on dyeing eri silk with natural dyes is very meager and requires to be established. New source such as Allamanda grandiflora was not used for dyeing textiles as per the available literature. Effort was made to standardise variables involved in extraction of the dyes and dyeing eri silk yarns. The standardisation procedures described under materials and methods were used and the evaluation was based on colour strength (K/S values) measured using colour flex spectrophotometer. Among the three mordanting methods, Pre mordanting method exhibited better&nbsp;&nbsp; results compare with simultaneous and post mordanted samples. Among the five mordants, alum and chitin mordanted samples exhibited good fastness followed by tartaric acid, ferrous sulphate and stannous chloride mordanted samples

Comparative study on gynaecological issues in adolescence among private and government school girls

Background: Gynaecological problems of adolescents occupy a special spectrum of gynaecological disorder of all ages. This is because of the transitional phase of the physical nature of the problems which are so unique, special and specific for the age group and also because of the associated physiological factors which are very important in the growth and psychological remodelling of someone in the transition between childhood and womanhood. The study conducted with the objective to assess the extent of awareness regarding adolescent changes and problems among school going adolescents and to compare the same between government and private school adolescent girls.Methods: We used a preformed questionnaire as our study material to assess the knowledge and attitude regarding nutritional requirement, BMI, obesity, puberty changes, menstrual hygiene and irregularities, anaemia, vaginal discharge, gynaecological tumours and HPV vaccine among the adolescent girls in both government and private schools and thereby, to compare the same between them.Results: Awareness regarding nutritional requirement (45%, 98%), BMI (66%, 15.5%), obesity related gynaecological problems (9%, 81%) and causes for anaemia (28%, 93%) were less in government school girls when compared private school girls. Awareness on menstrual hygiene was satisfactory in both the groups. Awareness on HPV vaccination was unsatisfactory in both the groups.Conclusions: Government school girls need better health education regarding adolescent related gynaecological issues. There is need to educate both the groups on HPV vaccination

Microemulsions- A Potential carrier for drug delivery

Microemulsions have attracted much interest over the past years as potential drug delivery systems because of their transparency ease of in preparation and long-term stability. Micro emulsions provide sustained or controlled drug release for different routes of administration including parenteral administration. It shows advantages in the drug delivery like greater absorption of drugs, alteration of the kinetics of the drug release and decreased toxicity are several advantages in the delivery process. In this article the microemulsion preparation techniques and applications were discussed in detail

Information needs of farmers on cultivation of salad cucumber Cucumis sativus under polyhouse

The conventional practice of crop production is now giving its way to hi-tech farming practices. Salad cucumber (Cucumis sativus), is a relatively new crop in Kerala and has proven yield benefit under polyhouse conditions. The study intended to assess the information needs of farmers regarding various technical and cultivation aspects of salad cucumber production under polyhouse. Kendall’s coefficient of concordance (W) and mean values were used to identify the information needs. Most of the cultivation aspects fell under either the ‘highly essential’ or ‘moderately needed’ information category. The technical aspects of construction, maintenance and repair of polyhouse were the most critical information need of farmers along with the specifics of fertilizers for polyhouse and fertigation system. Pests, diseases and nutrient deficiency problems were also the main concerns of farmers. Weed management and pollination, with low mean scores were among the least felt information need. Hence, these aspects are also found to be among essential needs. The study elucidated that an efficient information delivery system through appropriate channels is required to boost polyhouse cultivation of vegetables in Kerala

A Novel Method for Classification of Wrist Pulse for Health Monitoring using Sparse Classifier

A wrist pulse system has been developed that can detect both normal and abnormal conditions in patients based on wrist pulse diagnosis. Pulse diagnosis are mainly done in three steps they are pulse preprocessing, feature extraction and classification. The acquired wrist pulse signal is passed through consecutive stages of denoising, baseline wander removal and period segmentation. The feature extraction is then done to extract time domain, frequency domain and wavelet features. Classification is then done for finding normal and abnormal conditions using SVM (Support Vector Machine) classifier. It is found that by using the SVM classifier, distributed features cannot be efficiently identified, classification accuracy is low and sub-classification cannot be done for abnormal condition as SVM supports only binary data. So SVM classifier is replaced by sparse classifier which has higher accuracy since it supports highly nonlinear data. T test is used in feature selection so that it needs low memory and less time consumption. Sub-classification has been done for the abnormal cases of Anemia, Arrhythmia, Tuberculosis and Wolff Parkinson White Syndrome

Ferry Route Design with MAC Protocol in Delay Tolerant Networks

Delay Tolerant Networks(DTNs) are occasionally connected networks. They have high latency, long queuing time, limited resources and intermittent connectivity, which are different from traditional networks. They have been proposed to cope with challenges of communication in some extreme or special environments. Due to uncertainty of node mobility, application traffic demand and other factors, it is difficult to provide performance guarantee for a DTN where all nodes move arbitrarily. With controlled mobility, message ferry can be utilized to guarantee the network performance. MAC protocols developed for duty-cycled networks such as B-MAC,S-MAC, employ an extended preamble introduces X-MAC employs shortened preamble approach that retains the advantages of low power listening, namely low power communication, simplicity and a decoupling of transmitter and receiver schedules. Demonstrate through implementation and evaluation that xmac?s shortened preamble approach significantly reduces energy usage at both transmitter and receiver, reduces per-hop latency

Generating cadastral base for Kolathupalayam village in Tamil Nadu from high resolution LISS IV sensor data

In the present study an attempt was made to generate cadastral base from high resolution satellite image (LISS IV) and to integrate with land use land cover information. The digital cadastral map with survey number for Kolathupalayam village in Erode district of Tamil Nadu was scanned, digitized and parcels were extracted. Similarly parcels or field boundaries were digitized and extracted from satellite image and were statistically compared by area. The area obtained from both the source through digitization correlated well with a pearson correlation of 0.87 and it was significant at 5 per cent. Thus, the area comparisons from both methods are significant indicating boundaries of individual fields generated from satellite image matched well with the one generated from cadastral map. The cadastral base generated from satellite image was overlaid on the classified image (level III output) to identify and generate land cover information against each survey number. Thus, the LISS IV data can be used for the identification and extraction of cadastral boundaries with good accuracy

Calcium to creatinine ratio (CCR) and microalbuminuria as a recommendation for screening of preeclampsia

OBJECTIVES: The primary objective of this study is to determine predictive values of decreasing urinary calcium to creatinine ratio (CCR) and microalbuminuria for preeclampsia from a spot urine sample, in asymptomatic pregnant women between 20 to 24 weeks of gestation in order to recommend it as screening test. METHODS: Urinary calcium creatinine ratio and microalbumin was determined in a spot urine sample in 200 asymptomatic pregnant women between 20-24 weeks of gestation, who attended the antenatal OPD for routine antenatal care at RSRM Lying in Hospital, Chennai and followed till delivery. The results were analyzed by Chi- square test and Fisher-exact test to find the significant association of findings of preeclampsia and calcium-creatinine ratio and microalbuminuria. Area under Receiver Operator Curve (ROC) was used to find the predictive values of CCR at less than or equal to 0.04 and microalbuminuria > 30-300 mg/L for pre-eclampsia. RESULTS: From this study it was found that CCR had a sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 73.1%, 97.7%, 82.6% and 96% respectively with a statistical accuracy of 94.5% and p value of <0.001 (strongly significant). It was found to be a good test for prediction of preeclampsia. Microalbuminuria had sensitivity, specificity, PPV and NPV of 61.5 %, 88%, 38.1% and 93.7% respectively with a statistical accuracy of 82% and p value of <0.001 (strongly significant) and was found to be only a fair test for prediction of preeclampsia. CONCLUSION: CCR < 0.04 in a spot urine sample being a good test for prediction of preeclampsia can be recommended as a screening test for preeclampsia in all asymptomatic pregnant women. Urine microalbumin, when used alone cannot be used as screening test. Many more trials are needed to recommend it as a screening test

PTEROCARPUS MARSUPIUM HEARTWOOD EXTRACT RESTORES LEARNING, MEMORY AND COGNITIVE FLEXIBILITY IN A STZ-NA INDUCED DIABETES ANIMAL MODEL

Objective: Study was designed to assess the P.marsupium heartwood aqueous extract effect on diabetes induced cognitive impairment.Methods: Diabetes mellitus was induced by Streptozotocin (STZ) &amp; Nicotinamide (NA) intraperitoneal route injection. Animals were divided into 7 groups for comparing the activity of P.marsupium at two doses 250 mg/kg &amp; 500 mg/kg b. w against standard (Glibenclamide) &amp; controls groups. Rats having blood glucose above 250 mg/dL were considered as diabetic. Learning &amp; memory was tested using Morris water maze. Time taken to reach the platform (escape latencies) by animals was noted from day 1 to 8 and probe trial was conducted on day 9 to record the time spent in the different quadrants.Results: Blood glucose levels were significantly (p&lt;0.001) reduced in plant treated and glibenclamide groups when compared to diabetic controls. Also both the treated groups had decreased escape latencies in learning phase. During probe trial, test and standard treated groups spent significantly more time in target quadrant with less entries into other quadrants compared to untreated diabetic controls.Conclusion: The results of this investigation revealed that extract of P. marsupium provides beneficial effects on learning and memory in diabetes rats by providing the potential antihyperglycemic action.Keywords: Cognitive impairment, Diabetes mellitus, Diabetic neuropathy, Morris water maze, Pterocarpus marsupium heartwood