Forgotten double J stent in crossed renal fused ectopia: a rare case report

Ureteral double J (DJ) sent has now become one of the most commonly used tools in endourology. Complications are bound to occur if forgotten to remove, such as encrustations, infection, migration, renal dysfunction, hydronephrosis. Crossed renal fused ectopia is a very rare congenital malformation due to abnormal kidney ascent with fusion during embryogenesis in the first trimester. we report a very rare case of forgotten DJ stent in crossed fused ectopia, in 66 years old diabetic patient post left ureterorenoscopy (URS) done 3 years back. Retrograde intrarenal surgery (RIRS) was done for DJ stent removal right.

Effect of Municipal Solid Waste Open Dumping on Soil, Water, Crop, Human Health and Its Prospectives

Characterization of heavy metals in 5 Km2 range of dumping yard in relation to soil, water and crop has been studied. The concentration of Cd (4.05 mg/kg) in soil was higher than the permissible limit of WHO (3 mg/kg) and in descending order of metals in soil was found to be Fe> Cr>Cd>Ni>Zn>Cu>Pb and in bore well water it was Cr, Fe, Pb, Cd, Zn and Cu (23.20, 0.63, 0.31, 1.19 and 0.69 mg/l respectively) than the permissible limit (0.54, 0.40, 0.068, 0.03, 0.22, 0.018 mg/l) and their respective concentration ordered as Fe>Zn>Cu>Pb>Cd>Ni>Cr. Further the vegetables grown nearby dumping yard was highly contaminated by Cr in range (2.78 to 12.78 mgkg-1) in tomato, beans and cabbage and even in ragi and green gram Cr was high (1.78 to 14.96 mgkg-1). i.e., in Tomato; Cd>Fe>Cr>Zn>Pb>Ni>Cu, Beans; Cr>Cd>Pb>Fe>Zn>Cu>Ni, Cabbage; Cr>Cd>Pb>Fe>Zn>Cu>Ni, Ragi; Fe and Zn were below permissible limit and Pb, Ni, Cu, Cd are BDL and Green gram; Cr>Fe>Zn>Pb>Cu > Ni>Cd. In support of results, primary survey was conducted in nearby 20 villages circumventing the dumping yard. A total of 150 respondents were randomly enquired to know their level of knowledge and health status as result of open dumping site. The results revealed that 43.33%, 36% and 20.67% as medium, high and low impact in relation to heath and knowledge aspect of dumping site. Thus there is a considerable impact on environment and humans due to the presence of heavy metal in crop, soil and water.

A comparison of pain on intravenous injection to two formulations of Propofol, one containing medium chain and long chain triglycerides and the other without medium chain and long chain triglycerides

Background: To assess and compare the Visual Analog Scale (VAS) for pain on intravenous injection in patients receiving the two different formulations of Propofol.Methods: Total 170 eligible patients were randomized into Group A receiving Propofol MCT/LCT and Group B receiving Propofol LCT. After standard pre-anaesthetic preparation and baseline values recording, the blinded investigator recorded pain intensity after injection of 1mL study drug propofol, using Visual Analog Scale (0-10). Haemodynamic parameters were recorded every minute for 5 minutes. Calculated Propofol dose was injected in 20 seconds, and signs of pain (hand withdrawal, grimacing) were noted. After patient regained full consciousness, recall of injection pain was asked for.Results: The proportion of patients who experienced pain was similar in both groups (group A: 76/85 =89.41%, group B: 81/85 = 95.29%; statistically not significant (p value=0.247). Patients in group A had longer time for pain onset (11.3 seconds-group A Vs 9.8 seconds-group B; statistically significant, p value =0.008). Pain on injection was higher in Propofol LCT group as compared to Propofol MCT/LCT (VAS scores of group A=3.94±2.0 vs group B = 5.49±1.96; statistically significant; p value = 0.0018). Full dose of Propofol MCT/LCT produced significantly less pain when compared to Propofol LCT (p value = 0.0424). Recall of pain was comparable between the groups. Haemodynamic parameters (Heart rate and Mean Arterial Pressure) remained comparable in both groups.Conclusions: Pain on injection was higher and statistically significant in Propofol LCT group as compared to Propofol MCT/LCT.

Phycoremediation of carton box industry effluent using consortia of green microalgae Chlorella sp. and Scenedesmus sp. and phytotoxicity assessment

Industrialization, in the environmental context, has accumulated heavy metal concentrations considerable and it is adversely affecting biological system. In order to regulate heavy metal levels from effluents before their release into the environment, treatment of the wastewaters to reduce the content is mandatory. Phycoremediation is recognized as a cost effective technology for treating industrial effluents. The present study was carried out with the carton box manufacturing industry effluent contaminated with heavy metals collected from Peenya industrial area, Bangalore to determine the phycoremediation potential of algal consortium comprising of Chlorella and Scenedesmus. Microalgal species grown in wastewater with two different concentrations (50 and 100 %) were analyzed for their influence on algae growth, biomass and protein contents. Algae treated effluent showed the reduction of total solids, total dissolved solids and total suspended solids and heavy metal levels. These results indicate the efficacy of algal consortium for phycoremediation of carton box manufacturing industry effluent.

Anti-oxidant and Anti-microbial Activities of Silver Nanoparticles of Essential Oil Extracts from Leaves of Zanthoxylum ovalifolium

Aim: The present study was aimed to synthesis and characterization of silver nanoparticles (AgNPs) using Zanthoxylum ovalifolium leaf essential oil extracts and to screen the anti-oxidant and antimicrobial potential of the same. Place and Duration of Study: The studies were carried out at Department of Botany, AVK College for Women, Hassan and Department of Biochemistry, Aurora’s Degree & PG College, Hyderabad from July 2017 to June 2018 Methodology: The essential oil from leaves of Zanthoxylum ovalifolium was obtained by hydrodistillation and analyzed by GC and GC-MS. Synthesis of silver nanoparticles of essential oil extract was carried out and characterized by using UV-VIS spectroscopy and transmission electron microscopy (TEM). The total phenolic and flavonoid contents were estimated in all the extracts. Furthermore, all the extracts were evaluated for anti-microbial activity against two gram-positive and two gram-negative bacteria and four pathogenic fungi using agar disc diffusion technique. Subsequently the minimum inhibitory concentration (MIC) was also determined. Results: The major compounds identified were Limonene, isofenchol, Geijerene, isothujanol, Borneol, dihydrocarveol, isobornyl acetate, pregeijerene, b-elemene, trans-caryophyllene and Germacrene D. The TEM analysis of nanoparticles synthesized showed a size of 8 to 14 nm with a lmax of 450nm. All the extracts were evaluated for in vitro anti-oxidant activity where the AgNP of essential oil extract showed maximum activity of 89.61% and 84.92% respectively for both DPPH free radical scavenging and Hydrogen peroxide free radical scavenging assays at a concentration of 100µg/ml. Among all the bacteria tested, B. subtilis was most susceptible at 100µg/ml with zone of inhibition of 22.5mm. While among all the fungi tested, A. niger inhibited more effectively by the AgNP of essential oil extract at 100µg/ml with a zone of inhibition of 16.2mm. Conclusion: The results obtained were remarkable suggesting that AgNP of essential oil extract possess excellent anti-oxidant and anti-microbial activity and can be an alternative bio-friendly source for various pharmaceutical industries.

Spinal dysraphism: MRI evaluation.

Background: Spinal dysraphism refers to the entire range of spinal column and neuraxis anomalies. The objective was to evaluate the role of magnetic resonance imaging (MRI) in characterizing the congenital and developmental disorders of spine. Methods: Fifty (50) patients with clinically suspected spinal dysraphism were included in the study. All the patients were made to undergo MRI spine using 1.5 Tesla MRI, manufactured by GE, SIGNA HDX MACHINE. The findings of MRI spine were assessed and analyzed. Results: Out of 50 patients included in the study; 24 were male (48%) and remaining 26 were female (52%). Congenital spinal lesions were more prevalent in the age group 0-20 years (70%). Lesions without subcutaneous masses (62%) were more common than the lesions with subcutaneous masses (38%). The commonest location for the congenital spinal lesions was lumbar region (54%). Congenital spinal lesions without spinal curvature abnormalities (58%) were more common than the lesions with spinal curvature abnormalities (42%). Vertebral anomalies (78%) were the commonest spinal anomalies in patients with congenital spinal lesions; spina bifida was the commonest (46%). Diastematomyelia was more prevalent in the age group 0-10 years (41.66%) and in female population (58.33%). Conclusion: Thus we conclude that Spinal dysraphism were common in young females, with commonest anomaly being vertebral anomaly (Spina bifida), commonest location is lumbar region, Diastematomyelia common in young aged female. Magnetic resonance imaging is an accurate, noninvasive, safe and advanced modality for evaluation of the congenital spinal disorders and help in better management of these patients with prompt and accurate diagnosis.

Morquio’s Syndrome: A Rare Case.

Morquio’s syndrome is an autosomal recessive disorder due to deficiency of N-acetylgalactosamine-6 sulfate. Presented here is the case of a 4-year-old girl with complaints of deformity of bilateral lower limbs since 6 months. Examination revealed widely spaced teeth, corneal opacity, pectus carinatum, bilateral genu valgum and flat feet. X-rays of femur showed minimal metaphyseal widening, widened carpal bones and pointing metacarpals and beaking of the thoracic and lumbar vertebrae. She was diagnosed to be suffering from Morquio’s syndrome. Mucopolysaccharidoses (MPS) are a rare group of metabolic disorders due to deficiency of enzymes responsible for degradation of glycosaminoglycans. Treatment is mainly symptomatic.

Screening of proper leaf size in Centella asiatica for antioxidant potential and separation of phenolics using RP-HPLC.

Centella asiatica is a valuable medicinal plant with abundant amount of pharmaceutically useful compounds; however, it is important to know the proper physiological age for drug formulation. In the present study, smaller to larger thirteen groups of Centella asiatica leaves were evaluated for growth, chlorophyll content and antioxidant activity. The growth was measured in the terms of leaf area, fresh and dry weights and water content. Maximum antioxidant activity was found in third size group of the leaf which was further analyzed for phenolics in RP-HPLC. The probable role of these phenols in antioxidant activities is discussed.

A polyherbal formulation attenuates hyperoxaluria-induced oxidative stress and prevents subsequent deposition of calcium oxalate crystals and renal cell injury in rat kidneys / 中国天然药物

INTRODUCTION@#Cystone is an approved Ayurvedic polyherbal proprietary medicine used in India for various urinary disorders, including urolithiasis.@*AIM@#To evaluate the protective effect of Cystone against hyperoxaluria-induced oxidative stress and calcium oxalate crystal deposition in urolithiasis.@*METHODS@#Ethylene glycol (EG) (0.75%, V/V) in drinking water was given to rats for 28 days to induce urolithiasis with simultaneous treatment of Cystone (500 and 750 mg/kg body weight), and various urinary risk factors of urolithiasis and antioxidant markers were assessed.@*RESULTS@#EG treatment lead to increased urine volume and lowered urinary pH, along with increased urinary excretion of oxalate, calcium and phosphate in untreated animals. These changes caused extensive calcium oxalate crystal deposition, increased lipid peroxidation and decreased activity of antioxidant enzymes (SOD, catalase and GPx) in the kidney of untreated rats. Cystone prevented these hyperoxaluric manifestations and inhibited calcium oxalate crystal deposition in treated rats at both doses.@*CONCLUSIONS@#Cystone therapy provides protection against hyperoxaluria-induced oxidative stress and calcium oxalate crystal deposition by improving renal tissue antioxidant status and diuresis.

Mammary-type myofibroblastoma of soft tissue.

A 40-year-old woman presented with a 1 year history of a painless, subcutaneous lump on the right buttock. Clinical examination showed an approximately 6 cm large subcutaneous mass covered by apparently normal-looking skin. No inguinal lymphadenopathy was found. The mass was excised with the clinical diagnosis of fibroma. Histologically, the lesion was consistent with mammary-type myofibroblastoma of soft tissue, a very rare, benign mesenchymal neoplasm with myofibroblastic differentiation. After surgical excision she was free of recurrence over a period of 8 months. This article also challenges the theory that suggests the origin of this tumor to be from the embryonic mammary tissue, adding another case of a site other than the milk lines.

Evaluation of gabapentin in attenuating pressor response to direct laryngoscopy and tracheal intubation

Background: To evaluate effect of gabapentin in attenuation of haemodynamic responses to direct laryngoscopy and tracheal intubation. Methods: Hundred patients undergoing elective surgery were randomly allocated to two groups of 50 patients each. Patients in group A received gabapentin 800 mg and patients in group B received placebo capsules the night before and on the morning of surgery. Anaesthesia was induced with propofol and vecuronium. Systolic; diastolic; mean arterial blood pressures (SAP; DAP; MAP) and heart rate (HR) were recorded before and after the induction of anesthesia and 0; 1; 3; 5 and 10 min after tracheal intubation. Results: SAP was significantly lower in the gabapentin as compared to the control group 0; 1; 3; 5 and 10 min after intubation [121 vs 135 ( P0.001); 117 vs 132 (P0.001); 112 vs 124 (P0.001); 110 vs 118 ( P0.05) and 107 vs 112 ( P0.05) respectively]. DAP also was lower in the gabapentin group 0; 1; 3; and 5 min after intubation [77 vs 87 (P0.001); 74 vs 84 (P0.001); 70 vs 78 (P0.001) and 68 vs 74 (P0.05)]. MAP also was lower in the gabapentin group 0; 1; 3; and 5 min after intubation [92 vs 103 (P0.001); 88 vs 100 (P0.001); 84 vs 93 (P0.001) and 82 vs 88 (P0.05)]. HR also was lower in the gabapentin group 0; 1 and 3 min after intubation [90 vs 98 (P0.05); 88 vs 95 (P0.001) and 84 vs 90 (P0.05)]. Conclusion: Gabapentin; under the present study design attenuates the pressor response associated with laryngoscopy and tracheal intubation but tachycardiac response is not completely eliminated

The effect of pre-operative intake of oral water and ranitidine on gastric fluid volume and pH in children undergoing elective surgery.

The effect of pre-operative intake of oral water and ranitidine on gastric fluid volume and pH was studied in 75 children of American Society of Anesthetists (ASA) grade I and grade II undergoing elective surgery. Group I patients fasted from midnight and acted as control. Group II patients received 5 ml/kg plain water orally 3 hours before surgery. Group III children received 5 ml/kg of plain water and 2 mg/kg of ranitidine orally 3 hours before surgery. Mean volume of gastric aspirate was comparable in all 3 groups (p > 0.05). Mean pH was significantly higher in ranitidine treated patients (5.12 +/- 1.73) as compared to non-ranitidine treated patients (2.26 +/- 0.57 and 2.53 +/ 0.79 in group I and group II respectively). Number of patients at risk (pH < or = 2.5 and volume > or = 0.4 ml/kg) was not significantly different in group I and group II. Mean thirst and behaviour scores were significantly higher in fluid treated patients (groups II and III) as compared to control (p < 0.01). To conclude, administration of pre-operative water (5 ml/kg) along with ranitidine (2 mg/kg) favourably modifies gastric fluid volume and pH, improves patient behaviour and minimises the number of patients at risk of aspiration pneumonitis, should the child aspirate.