A case of intradural lumbar disc herniation.

Key Clinical Message: MRI remains the best tool in the diagnosis of this disease entity however preoperative diagnosis remains a difficult task. A high degree of suspicion is raised when intraoperative findings and preoperative image description become incompatible. Abstract: Lumbar disc herniation into the dural space is a rare phenomenon of lumbar disc degeneration with an unclear remaining pathogenesis. Intraoperative ultrasonography and histopathological examination of resected specimen help in the diagnosis of intradural disc herniation. Prompt surgery is recommended due to the high incidence of cauda equina syndrome.

A Rare Case Report of Giant Urinary Bladder Stone Causing Recurrent Dysuria in a Woman.

Background: Large urinary bladder stones are not common and even less common in females. We report a case of large bladder stone presented with acute retention of urine in a female patient. Case Report. A 62-year-old female presented in emergency department with retention of urine for 12 hours with history of recurrent UTIs for last 1 year. She was also complaining of mild dull lower abdominal pain for last 6 months. She had no history of incontinence of urine and fever. On physical examination, hard mass was palpable on suprapubic region on palpation of abdomen. Urine culture shows Escherichia coli for which antibiotics was given. An X-ray kidney ureter bladder showed a radio-opacity in the pelvic region measuring 9 × 8 cm in size. Ultrasonography revealed bilateral mild hydronephrosis with a large bladder stone. Open cystolithotomy was performed, and the stone was taken out. Stone biochemical analysis showed predominantly urate crystals. Patient had uneventful postoperative course, and she was discharged on 4th postoperative day and was followed up for 1 months after operation. Conclusions: Large urinary bladder stones are not common and even less common in females. Clinician should have think regarding large bladder stone as a cause of recurrent lower urinary tract symptoms like dysuria and should assess renal function for proper treatment. Open cystolithotomy is choice of operation in large bladder stone.

How will hydro-energy generation of the Nepalese Himalaya vary in the future? A climate change perspective.

Despite being one of the proven clean-energy technologies, hydroelectricity is losing attention in global research. Hydroelectricity is extremely important for countries possessing the required water resources, already heavily reliant on it and those lacking the financial capacity to invest in other expensive energy technologies. This study assessed the possible impact of climate change (CC) on hydro-energy generation in the Nepalese Himalaya (possessing eight peaks out of 14 over 8000 m) with a tremendous hydropower potential (∼50,000 MW). A planned 1200 MW storage type Budhigandaki Hydroelectricity Project is taken as a case. We estimated the energy generation for the baseline as well as 10 CC scenarios considering RCPs 4.5 and 8.5 at monthly, seasonal, and annual temporal scales for the mid-century. Results show that energy generation is highly dependent on the reservoir operating rule. The average annual energy generation is expected to vary within -5 to +12% of the base case in the mid-century, with significant variations across the months. We also infer that designing hydro-projects based on ensembled climate values could lead to a "rosy" but less probable and risky picture of energy generation in the future. Therefore, assessment of a wide spectrum of plausible CC scenarios are recommended. Storage type projects with provision of flexible operating rules considering finer temporal resolution and allocation to competing users (in case of multipurpose projects) supported by appropriate policies are desirable for climate resiliency. Complementing the existing energy generation mix with other technologies in areas where hydroelectricity is expected to undergo adverse impacts of CC is warranted for attaining future energy security and environmental safeguarding. Possibility of additional energy due to CC is a strong motivation for this region to focus on hydroelectricity development in the future.

Assay of renewable energy transition: A systematic literature review.

Issues of environmental degradation, finite quantity and uneven spatial distribution of fuels in nature, and growing demand accentuated by volatility of oil prices have led to the global clean renewable energy transition (RET). With an objective of examining the current knowledge-stock on RET, we reviewed 248 journal publications pooled from three databases (ScienceDirect, Web of Science and Scopus) using a Systematic Literature Review method. This study does not focus on the specifications of a particular energy technology or regress relations among a limited set of variables. Rather, the key contribution is the critical assessment of the factors that encourage and those that hinder the transition process to provide a wider perspective through seven broad lenses: technological, investment, market, environmental, government and institutional, policy and social. Research, development and implementation of technology is a direct outcome of policy investment. Developed countries are leading the RET research while the global south is far behind. Most of the studies were found to be donor-driven which faced a serious risk of being counter-welcomed in different settings of the world without compromising the objectives of the transition. A strong international collaboration among the rich and poor countries is urgently felt necessary to foster mutual benefits. Research, planning and implementation of the RET would be highly effective and sustainable through a participatory bottom-up approach promoting local technology instead of imposed expensive imported ones. The need for "demand-pull" and "technology-push" policy instruments is stringent for successful transition. We conclude that there is a unanimous agreement among all the studies on the future prospects of renewable energy in the electricity sector; however, some skepticism still exists regarding other high energy demanding areas. Our review recommends updating existing and designing new robust policy mixes to guide the modality and pace of the RET, adhering to local specificities.