Biliary hyperkinesia: A potentially surgically correctable disorder in adolescents

AbstractBiliary colic, which is characterized by intermittent, usually postprandial, right upper quadrant pain, is a common complaint in the pediatric population and usually prompts further evaluation with an abdominal ultrasound. Those patients without evidence of cholelithiasis are sometimes referred for a hepatobiliary iminodiacetic acid scan with cholecystokinin stimulation (CCK-HIDA) to assess gallbladder function. When the gallbladder empties poorly, the diagnosis of biliary dyskinesia, defined as a gallbladder ejection fraction less than 35%, is made, and cholecystectomy can be considered. There is a subset of symptomatic patients, however, who have an abnormally high ejection fraction, defined as greater than 65%. The approach to the treatment of these patients with biliary hyperkinesia is still undetermined, as there is little in the literature regarding this entity. With IRB approval (protocol #1307002185), we report our series of three adolescent females found to have biliary hyperkinesia whose symptoms immediately resolved following laparoscopic cholecystectomy

Effect of Site-disorder, Off-stoichiometry and Epitaxial Strain on the Optical Properties of Magnetoelectric Gallium Ferrite

We present a combined experimental-theoretical study demonstrating the role of site disorder, off-stoichiometry and strain on the optical behavior of magnetoelectric gallium ferrite. Optical properties such as band-gap, refractive indices and dielectric constants were experimentally obtained by performing ellipsometric studies over the energy range 0.8 eV to 4.2 eV on pulsed laser deposited epitaxial thin films of stoichiometric gallium ferrite with b-axis orientation and the data was compared with theoretical results. Calculations on the ground state structure show that the optical activity in GaFeO3 arises primarily from O2p-Fe3d transitions. Further, inclusion of site disorder and epitaxial strain in the ground state structure significantly improves the agreement between the theory and the room temperature experimental data substantiating the presence of site-disorder in the experimentally derived strained GaFeO3 films at room temperature. We attribute the modification of the ground state optical behavior upon inclusion of site disorder to the corresponding changes in the electronic band structure, especially in Fe3d states leading to a lowered band-gap of the material.Comment: 18 Pages, 6 figure

Axial Conduction in a Partially Heated Microchannel Subjected to Isothermal Boundary Condition

A numerical study has been carried out to study the effects of axial conduction in a conjugate heat transfer situation involving simultaneously developing laminar flow and heat transfer in a square microchannel subjected to constant wall temperature at bottom of substrate while the other exposed surfaces are kept insulated. The study is carried out for different partial heating cases. They are: (i) The entire bottom surface of microchannel is subjected to constant wall temperature while all other outer surfaces are insulated (ii) 6 mm of bottom surface is insulated from both inlet and outlet end of micro channel and remaining length of bottom surface is subjected to constant wall temperature (iii) 6 mm of bottom surface is insulated from inlet end of micro channel and remaining length of bottom surface is subjected to constant wall temperature (iv) 6 mm of bottom surface is insulated from outlet end of micro channel and remaining length of bottom surface is subjected to constant wall temperature. Simulations are carried out for different conductivity ratio, Re and substrate thickness to channel depth ratio. It is found that value of Nuavg is increasing with decreasing value of ksf upto ksf approximately equal to 25 and beyond that on decreasing ksf value further, value of Nuavg starts decrease rapidly. This sudden decrease in Nuavg value is because under such situation the case becomes a one side heating problem rather than three sided heating problem. Now as ksf is increased beyond a range axial back conduction comes into play and this causes value of Nuavg to decrease. Thus, there exists an optimum ksf for which Nuavg is maximum for given flow Re and wall thickness ratio. Secondly, it is observed that higher axial conduction causes the boundary condition experienced at the solid fluid interface to drift more towards iso-flux condition although isothermal condition is applied on outer surface

Successful pregnancy outcome in a patient with Robertsonian translocation (13; 14) (Q10:Q10) with recurrent pregnancy loss

Robertsonian translocations are unique type of whole-arm translocation that result from ‘centric fusion’ of the long arms of two acrocentric chromosomes with loss of the short arms, thus reducing the number of chromosomes by one. RT’s are present in 0.1% of the general population and 1% of the infertile population. Most frequent type of RT includes translocation rob (13; 14), whereas translocation rob (13; 15) and rob (14; 15) are rare. In the present report, RT in a female with spontaneous repeated abortions and infertility is reported. Cytogenetic analysis of a couple with repeated abortions revealed the presence of 45, XX, rob (13; 14) (q10; q10) chromosomal constitution in the female partner. The patient conceived after diagnostic laparoscopy followed by ovulation induction and intra uterine insemination and with proper antenatal care and support she delivered a healthy male baby with normal karyotype. The history of repeated abortions and infertility could be the outcome of unbalanced gametes (either monosomy or trisomy) resulting during the meiotic segregation of the balanced heterozygote female carrier. Cytogenetic analysis should be offered to all couples with unexplained recurrent abortions to evaluate the probable presence of any chromosomal aberrations

Mathematical Model Based Control System for Silicon Steel Mill of Rourkela Steel Plant

AbstractReactive annealing of semi-processed electrical steels is an important process to reduce electro-magnetic losses. The annealing process involves heating of the steel strip, which is passed continuously through the furnace, to a certain temperature. The heated steel strip gets decarburised and annealed in a warm gas atmosphere containing N2-H2-H2OCO-CO2 mixture. The composition of the warm gas atmosphere plays a major role in both the decarburisation and selective oxidation of carbon from the steel strip. The furnace settings are often changed to cater for products with different metallurgical properties and varying dimensions. Often the line speed of the process too needs to be changed to cater to varying input parameters of the steel strip such as composition, width, thickness etc. Thus an advanced mathematical model based system is desired to optimize the running of the furnace to achieve the desired properties at improved productivity.For effective control of system, mathematical model for the heating of the steel strip is developed. Decarburisation model for the steel strip has been coupled with the thermal model. The model takes in various inputs like line speed, composition of the steel strip, width and its thickness. Temperatures in the different zones of the furnace along with the decarburising gas flow rate, H2/H2O ratio etc, are taken as input parameters. The model predicts the thermal profile of the steel strip inside the furnace. It also predicts the carbon composition in the steel strip along the length of the furnace. Based on optimized temperature and carbon profile for different grades, the model suggests the desired line speed and the temperature settings in the different zones of the furnace. If there is a mismatch in the desired and the actual line speed the model also generates the desired set points of temperature for increasing or decreasing the furnace temperature which is downloaded to PLC in order to control the furnace parameters in real-time

Regeneration Status and Carbon Accumulation Potential in Community Managed Sal (Shorea robusta) Forests of Far-Western Terai Region, Nepal

Regeneration patterns of species population can address climate change by adaptive evolution or by migrating association to survival in their favorable climate and finally decide the particular forest future. This research examined the status of regeneration and carbon sequestration potential in tropical Sal (Shorea robusta) forest of Kanchanpur district, Nepal. For the study, a total of 63 concentric sample plots were investigated by using systematic sampling with 0.5% sampling intensity. Regeneration status of forest was estimated by calculating the density of each species in each developmental phase. The above-ground carbon stock of trees species were estimated using allometric equations. The studied forests had good regeneration status and Shorea robusta was the dominant species in terms of regeneration and carbon stock. Ramnagar community forest had greater number of seedling, sapling and tree than that of the Ganesh community forest. Reverse J-shaped population curves were recorded at both the study sites. This study provided information about the regeneration status, structure, composition and carbon sequestration potential of tree species which is very necessary for conservation and sustainable management of community forests. Studies indicate that community management has increased the carbon stock of forests and also has promoted the productivity of forests by altering the structure and composition of the community forests

Infrared (8-12 um) Dome Materials: Current Status

The 8-12 um range of infrared radiation being very significant for various electrooptic applications, various materials present themselves as candidates for use as dome (window) materialsin this range. This paper discusses various thermal, mechanical and optical properties of thesematerials. Further, trends in the development of these materials are also presented

To study the cost variation analysis of oral H2 receptor blockers available in different brands in Indian pharmaceutical market

Background: Aim of the study was to study percentage price variations among different brands of the commonly prescribed H2 receptor blockers.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition, Drug Today April to June 2018 Vol-1. The price ratio and the percentage price variation for individual drug brands was calculated. The price of 10 tablets/capsules were calculated. At last the price ratio and percentage price variation of various brands were compared.Results: Percentage variation in price for H2 receptor blockers marketed in India was found to be tablet cimetidine 200mg:81.89, tablet cimetidine 400mg:91.27, tablet ranitidine 150mg:295.64, tablet ranitidine 300mg:123.19, tablet famotidine 20mg:939.62, tablet famotidine 40mg:1110.09, tablet roxatidine 75mg:38.65, tablet roxatidine 150mg:21.85.Conclusions: H2 receptor blocker is the most common drug prescribed for prolonged period in case of gastritis, Gastro-Esophageal Reflux Disease (GERD), peptic ulcer. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. The doctors prescribing these drugs should be aware of these variations in price to reduce the price of drug therapy

Water quality of springs and lakes in the Kumaon Lesser Himalayan Region of Uttarakhand, India

The scarcity of drinking water has become a bitter reality in many countries. The gap between demand and supply of water has been increasing exponentially year by year. Deforestation, vigorous use of groundwater for agricultural practices, and pollution of our present water resources such as rivers, lakes, and wells are triggering the freshwater scarcity problem. Ninety percent of people in Uttarakhand depend on springs for their daily life activities. In such a case, the quality and quantity of spring water should be a prime topic to be focussed on. In the Kumaon region of Uttarakhand, spring water quality is good but there is an issue with its availability, especially in summer. This review paper details the studies that have been conducted on nutrient status, hardness, heavy metals, and the presence of microbiological diversity in spring water. It also uncovers information on some critical springs, geological settings of their aquifers, and the steps that have been adopted to rejuvenate the spring. Some other measures have been carried out by the government and local communities for springs’ revival and their improvement in discharge rate, including the construction of percolation pits, contour trenches, check dams, and improvement of water resources. It has been observed among the analyzed sample that the Kumaon region is dominated by arsenic, cadmium, chromium, and lead, whereas aluminum, barium, cobalt, and manganese are more in the Garhwal region. Apart from springs, this review paper also reveals the physicochemical characteristics of the spring-fed rivers and lakes of the Kumaon region

Association of dopaminergic pathway gene polymorphisms with chronic renal insufficiency among Asian Indians with type-2 diabetes

<p>Abstract</p> <p>Background</p> <p>Genetic markers conferring susceptibility to diabetes specific renal disease remains to be identified for early prediction and development of effective drugs and therapies. Inconsistent results obtained from analysis of genes from classical pathways generate need for examination of unconventional genetic markers having role in regulation of renal function. Experimental and clinical evidences suggest that dopamine is an important natriuretic hormone. Therefore, various genes involved in regulation of dopamine bioavailability could play a role in diabetic chronic renal insufficiency (CRI). We investigated the contribution of 12 polymorphisms from five Dopaminergic pathway genes to CRI among type-2 diabetic Asian Indian subjects.</p> <p>Methods</p> <p>Genetic association of 12 polymorphisms (SNPs) from five genes namely-dopamine receptor-1 (<it>DRD1</it>), <it>DRD2</it>, <it>DRD3</it>, <it>DRD4</it>, andcatechol-O-methyltransferase (<it>COMT</it>) with diabetic CRI was investigated using a case-control approach. Logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study pair wise interactions between SNPs of different genes.</p> <p>Results</p> <p>SNPs <it>-141 ins/del C and G>A </it>(1 kb upstream from exon 2) in DRD2 gene showed significant allelic and genotypic association. Allele <it>-141 insC </it>and genotype <it>-141 insC/insC </it>of <it>-141 ins/del C </it>polymorphism, and allele A of <it>G>A </it>SNP were found to be predisposing to CRI. Our result of allelic and genotypic association of -<it>141 insC/delC </it>SNP was also reflected in the haplotypic association. Heterozygous genotype of polymorphism <it>900 ins/del C in COMT </it>gene was predisposing towards CRI.</p> <p>Conclusion</p> <p>Some polymorphisms in <it>DRD2 </it>and <it>COMT </it>genes are significantly associated with susceptibility to CRI in the Asian Indian population which, if confirmed would be consistent with a suggested role of dopamine metabolism in disease occurrence.</p