Types of Renal Stones and its Variation with Age and Gender in a University Hospital of Nepal

Background Types of renal stones have profoundly changed in the last half-century, parallel to the change in lifestyle and dietary habit, with an increase of calcium stones. Among many lithogenic factors age and gender are considered to be associated with the types of renal stones. Studies evaluating the influence of age and gender on the distribution of the types of urinary calculi are scarce in Nepal. Objective To explore the influence of age and gender on different types of urolithiasis. Method This is a single center prospective study encompassing urolithiasis during a study period of 18 months. All the stone retrieved from the patients after surgery were sent for biochemical analysis of the stone. The result was then compared with the age and gender of the study population. Result Calculi from a total of 107 patients wereanalyzed (62 from malesand 45 from females). Mixed stones consisting of calcium oxalate and calcium phosphate werethe predominant constituent in 74.16% of stones, followed by uric acid, struvite and cystine stones. We found predominance of Calcium stones in males(47.66%) vs 36.44% in females and predominance of struvite stonesin females (7.47%) vs 3.73% in males. Age group of 21-40 years has the main burden of stone. Conclusion Being aware and having better knowledge of risk factors, composition and correlation with age and gender can provide personalized guidance to prevention and avoid recurrence of urolithiasis.

Recovery Pattern in Different Surgical Approaches on Thoracic Enhanced Recovery based Fourteen-Step Protocol in Patients Undergoing Cardio-thoracic Surgery at University Hospital of Nepal

Background Cardio-thoracic surgery involves open and minimally invasive techniques. Enhanced recovery after surgery is used for early recovery from surgery. Enhanced recovery after surgery decreases hospital stay duration. Patients undergoing Enhanced recovery after surgery after video assisted thoracic surgery use less pain killers and have less hospital cost. There has not been any study on outcomes on patient who follow physiotherapy protocol designed in our setting. Objective To find the physiotherapy outcomes in patients undergoing thoracic enhanced recovery after surgery (T-ERAS) based 14 step protocol locally designed at Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH). Method This is a retrospective cross sectional observational study. All the cases who underwent cardiothoracic surgery were classified based on the approach of chest surgery performed into groups Sternotomy, Thoracotomy and Video Assisted Thoracic Surgery (VATS) groups. Patients were advised for Thoracic Enhanced recovery after surgery based on the protocol that has been devised at Dhulikhel Hospital. The recovery of patients based on activities they could perform was noted and analyzed. Result Both ICU stay and hospital stay in number of days were highest in thoracotomy (6.04 days) group while that was lowest in video assisted thoracic surgery group (1.67 days). There is a similar recovery until step 5, i.e. 2 days and rapid progression in further steps in video assisted thoracic surgery group while it is much slower in both sternotomy and thoracotomy groups. Conclusion Postoperative mobilization and physiotherapy enhance early healing and decrease hospital stay. Mean hospital stay and ICU stay were shorter for video assisted thoracic surgery cases compared to Thoracotomy and Sternotomy groups and the mean days to achieve different steps varied within the protocol between groups compared.

Enhanced magnetic and room temperature intrinsic magnetodielectric effect in Mn modified Ba2Mg2Fe12O22 Y-type hexaferrite

We have reported a systematic investigation on structural, magnetic, magnetodielectric and magnetoimpedance characteristics of Y-type Ba₂Mg₂(Fe_1-x Mn _x )₁₂O₂₂ (0  ⩽  x  ⩽  0.12) hexaferrite synthesized by solid-state reaction route. Rietveld refinement of x-ray diffraction pattern confirms the phase purity of all the samples with rhombohedral crystal structure. The Mn dopant modulates not only superexchange angle near to the boundary of magnetic blocks but also magnetic transition temperature. Temperature-dependent magnetization data suggests that due to Mn doping at Fe sites, ferrimagnetic to proper screw transition temperature (T _II) increases from 190 K to 208 K, while there is a decrease in proper screw to longitudinal conical spin transition temperature (T _I) from 35 K to 25 K. We observe remarkable decrease in the magnetic field from 20 kOe to 12 kOe to produce intermediate spin ordering from ferrimagnetic ordering which can be understood because of modification of superexchange angle due to Mn doping. The value of loss tangent decreases with increasing doping concentration at 300K, i.e. ~60% and 180% in BMFM4 (x  =  0.04) and BMFM8 (x  =  0.08) respectively as compared to BMF, suggesting the evolution of intrinsic feature in the doped samples. Magnetodielectric (MD) effect shows that in the low-frequency regime, the robust MD effect is because of Maxwell-Wagner interfacial polarization, whereas in the high-frequency regime intrinsic effect dominates. Further, magnetoimpedance measurement confirms the presence of substantial intrinsic MD% (~6%) at 1.3 T applied field at 300 K for 4% Mn-doped sample. Finally, the nature and strength of magnetoelectric coupling in BMFM4 and BMFM8 samples at 300 K is found to be biquadratic (P ² M ²) and maximum strength of coupling is 3.09  ×  10^-4 emu² g^-2 and 2.34  ×  10^-4 emu² g^-2, respectively.

Genetic and genomic approaches to address rapid rancidity of rice bran

Rice bran is an invaluable by-product of paddy processing industry. It is rich in minerals, protein, lipids, and crude fiber. In addition, it also possesses compounds with anti-oxidant, anti-allergic, anti-diabetic, and anti-cancer properties. It forms a basis for the extraction of rice bran oil and preparation of various functional foods with health benefits and potential to prevent chronic health issues. Nevertheless, the rapid deterioration of bran upon storage acts as a major limitation in exploiting the full potential of rice bran. In this review, we have discussed three strategies to address rapid rancidity of rice bran and enhance its shelf life and storability vis-a-vis emphasizing the importance of rice bran in terms of its nutritional composition. One strategy is through exploitation of the null mutations in the genes governing lipases and lipoxygenases leading to nonfunctional enzymes (enzyme deficient approach), another strategy is through reducing the PUFA content that is more prone to oxidation (substrate deficient approach) and a third strategy is through enhancing the antioxidant content that effectively terminate the lipid peroxidation by donating the hydrogen atom.

Effects of a combination of xylanase, amylase and protease, and probiotics on major nutrients including amino acids and non-starch polysaccharides utilization in broilers fed different level of fibers

This study evaluated the effects of a combination of xylanase, amylase, and protease (XAP), with probiotics (3 Bacillus spp.) supplementation on apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of nutrients in Cobb 500 broilers from 0 to 21 d. A completely randomized 2 × 4 factorial design (2 levels of fiber; 4 types of supplements) with 8 replicate cages (6 birds/cage) was used. Each low and high-fiber diet contained 500 FTU/kg Buttiauxella sp. phytase and was supplemented with: (a) none (control), (b) XAP (2,000 U xylanase + 200 U amylase + 4,000 U protease/kg diet), (c) probiotics (75,000 CFU/g of Bacillus spp.), or (d) XAP + probiotics. High fiber decreased (P < 0.05) nitrogen-corrected apparent metabolizable energy (AMEn), AID of all amino acids (AA), AID and ATTD of dry matter (DM), crude protein (CP), starch, and gross energy (GE). High fiber increased (P < 0.01) the flow of total non-starch polysaccharides (NSP) in both ileum and total tract. The XAP + probiotics increased (P < 0.01) AMEn as well as AID and ATTD of DM, CP, GE, starch, while alone, XAP yielded similar improvement except for DM compared with control. The supplemental XAP alone improved (P < 0.01) the digestibility of most of the AAs compared with control. Moreover, XAP + probiotics increased (P < 0.05) AID of all AA except arginine and serine compared with control. A fiber × supplements interaction (P < 0.05) was found for AID of histidine and threonine, and their digestibility in high-fiber diet was improved to a level comparable to low-fiber diet by XAP + probiotics. The flow of NSP in XAP group was 5 to 6% lower than in control while NSP flow in XAP + probiotic group was further 4% lower than that of XAP group (P < 0.01). The results infer that the combination of XAP and probiotics can effectively optimize the nutrient digestibility in broilers fed both low and high-fiber diets.

Outcome of Uretero Renoscopic Lithotripsy (URSL) with Holmium LASER Vs Pneumatic Lithotripter for Lower Ureteric Stones, Experience from University Hospital of Nepal

Background There are various methods of endoluminal ureteral stone fragmentation. Among various modalities Laser lithotripsy and Pneumatic lithotripsy are commonly used and have shown comparable outcomes. Objective To compare the efficacy and outcome of laser and pneumatic lithotripsy in a patient with lower ureteric calculi. The comparison will be done in stone free rate, migration of stone and complication of the procedure. Method This is a prospective comparative study in a cohort of patients at University Hospital with Lower Ureteric stone. Ninety patients were randomized in to two groups (Laser Lithotripsy Vs Pneumatic Lithotripsy) during the study period. The purpose of this study was to measure the immediate stone free rate, intra-operative complications, mean operative time, post-operative complication and if any stone retention after six weeks follow up. Result Both the groups were similar in Age and Gender. Immediate stone free rate was slightly higher in Laser lithotripsy group (97.77%) in comparison to Pneumatic lithotripter group (84.44%) with p=0.507 which is not statistically significant. There was statistical difference in terms of stone migration rate, mean operation time in favor of Laser Lithotripsy group (p<0.01, in both parameters). There were no immediate complications in both the group however there were three cases of short segment ureteric strictures (6.66%) in case of Pneumatic lithotripsy on six weeks follow up which was managed conservatively. Conclusion Both LASER lithotripter and Pneumatic lithotripter are equally efficacious modality of endoluminal URSL in lower ureteric stone with similar Stone Free Rate. Laser lithotripsy showed lower frequency of stone migration and had shorter procedure time.

Open Surgical Management of Abdominal Aortic Aneurysm at a Community Based University Hospital in Nepal

Aortic aneurysms are abnormal dilatation of aorta. The risk factors include male sex, age > 65, smoking, coronary artery disease and hypertension. Here we report a case of infra-renal abdominal aortic aneurysm (AAA) of diameter 6 cm. The patient sucessfully underwent aorto-biiliac bypass surgery using Dacron Y graft. During abdominal aortic aneurysm surgery anesthetic challenge is also of paramount importance and should be considered.

Management and design of biogas digesters: A non-calibrated heat transfer model

A thermal balance modeling framework is developed, based on heat transfer-resistance networks. The heat transfer model accounts for effects of digester- design, location and operation, including effects of solar irradiance, external heating and ambient climate. We demonstrate extendibility of the framework by using the model in dynamic simulations of substrate temperature for digesters comprising two very different designs. Digester designs modeled include fixed-dome, buried, uninsulated and unheated household digesters in Hanoi, Vietnam, and an industrial-scale anaerobic digester located at a wastewater treatment plant in Esbjerg, Denmark. The modeled temperature profiles were evaluated against measured substrate temperatures over long periods, from 7 months and up. For the two Hanoi digesters, root-mean-square-error were 1.43 °C and 0.92 °C, with Nash-Sutcliffe model efficiency coefficients (NS-C) of 0.87 and 0.93 respectively. For the industrial digester in Esbjerg root-mean-square-error was 0.48 °C with an NS-C of 0.94. The model was not calibrated prior simulation, suggesting good predictive performance.

Sentinel Lymph Node Biopsy in Colon Cancer: an Institutional Experience

Lymph node staging is a major prognostic factor in colorectal cancer and remains to be the most important criterion for selecting patients for adjuvant therapy. The standard approach for lymph node evaluation is based on manual dissection and histological evaluation of HE-stained slides. For stage III disease (node positive), adjuvant chemotherapy increases the survival rate, while in node-negative stage II disease, in most cases, the chemotherapy is contraindicated due to increased morbidity without real benefit. Up to 30% of patients with node-negative colon cancer staged by standard pathologic techniques ultimately suffer disease recurrence and tumour-related mortality following potentially curative primary resection. Variations in outcome among patients with node-negative early-stage disease may reflect inadequate nodal resection and inaccuracies of pathologic staging. Hence, an accurate pN stage becomes essential. It is seen that classic pathological exam sometimes fails to identify lymph node micrometastases or isolated tumour cells, which might explain local or distant relapses in stage II patients. Sentinel lymph node study has the potential to detect micrometastases and lead to upstaging the disease which is crucial for planning adjuvant therapy and follow-up in these patients. In our study, we carried out SLNB in 40 clinically stage II patients operated for colon cancer. We used peritumoural injection of dye at the time of surgery to detect SLN(s) and analysed them using both microsectioning and immunohistochemical (IHC) staining. Our results show that SLNB can improve the accuracy of pTNM staging.

A case of thymoma in myasthenia gravis: Successful outcome after thymectomy

INTRODUCTION

Thymic abnormalities occur as hyperplasia and thymoma. Myasthenia gravis is commonly present in thymoma. Thymectomy possesses risk due to anatomical proximity with vital thoracic structures and myasthenia crisis.

PRESENTATION OF CASE

Forty five years female with complaints of difficulty swallowing and weakness of upper limb muscles upon investigation showed mass in mediastinum and antibody test for myasthenia gravis positive. Medical management was done for a month followed by thymectomy. There were no intra and postoperative complications. Medical management was stopped one month after surgery and she is symptom free.

DISCUSSION

Thymectomy is the standard of care where median sternotomy is the mainstay approach to surgery. Various other surgical approaches and complications revolving around surgery has been discussed.

CONCLUSION

Surgical removal of thymoma cured myasthenia gravis in our case. We focused on proper preoperative optimization of myasthenia gravis symptoms before thymectomy.

High-throughput screening against protein:protein interaction interfaces reveals anti-cancer therapeutics as potent modulators of the voltage-gated Na+ channel complex

Multiple voltage-gated Na⁺ (Nav) channelopathies can be ascribed to subtle changes in the Nav macromolecular complex. Fibroblast growth factor 14 (FGF14) is a functionally relevant component of the Nav1.6 channel complex, a causative link to spinocerebellar ataxia 27 (SCA27) and an emerging risk factor for neuropsychiatric disorders. Yet, how this protein:channel complex is regulated in the cell is still poorly understood. To search for key cellular pathways upstream of the FGF14:Nav1.6 complex, we have developed, miniaturized and optimized an in-cell assay in 384-well plates by stably reconstituting the FGF14:Nav1.6 complex using the split-luciferase complementation assay. We then conducted a high-throughput screening (HTS) of 267 FDA-approved compounds targeting known mediators of cellular signaling. Of the 65 hits initially detected, 24 were excluded based on counter-screening and cellular toxicity. Based on target analysis, potency and dose-response relationships, 5 compounds were subsequently repurchased for validation and confirmed as hits. Among those, the tyrosine kinase inhibitor lestaurtinib was highest ranked, exhibiting submicromolar inhibition of FGF14:Nav1.6 assembly. While providing evidence for a robust in-cell HTS platform that can be adapted to search for any channelopathy-associated regulatory proteins, these results lay the potential groundwork for repurposing cancer drugs for neuropsychopharmacology.

Effect of temperature on Pi54-mediated leaf blast resistance in rice

Assessment of temperature effect on plant resistance against diseases has become essential under climate change scenario as temperature rise is anticipated to modify host resistance. To determine temperature influence on resistance gene, a pair of near-isogenic rice lines differing for the Pi54 resistance gene was assessed against leaf blast. Blast resistance was determined as the extent of infection efficiency (IE) and sporulation (SP) at suboptimal (22 °C and 32 °C) and optimal temperature (27 °C) of pathogen aggressiveness. Relative resistance for IE and SP was higher at suboptimal temperature as compared to that of optimal temperature. Maximum level of resistance was at 22 °C where higher levels of expression of Pi54 and defence-regulatory transcription factor WRKY45 were also noted. At 32 °C, although some level of resistance noted, but level of Pi54 and WRKY45 expression was too low, suggesting that resistance recorded at higher temperature was due to reduced pathogen aggressiveness. At the optimal temperature for pathogen aggressiveness, comparatively lower levels of Pi54 and WRKY45 expression suggest possible temperature-induced interruption of the defence processes. The variation in resistance patterns modulated by temperature is appeared to be due to pathogen's sensitivity to temperature that leads to varying levels of Pi54 gene activation. Quick and violent activity of the pathogen at optimal temperature came into sight for the interruption of defence process activated by Pi54 gene. Evaluation of blast resistance genes under variable temperature conditions together with weather data could be applied in screening rice genotypes for selection of resistance having resilience to temperature rise.

Spatio-temporal temperature variations in MarkSim multimodel data and their impact on voltinism of fruit fly, Bactrocera species on mango

Fruit flies are the most serious economic insect pests of mango in India and other parts of the world. Under future climate change, shifts in temperature will be a key driver of ecosystem function especially in terms of insect pest dynamics. In this study, we predicted the voltinism of the three economically important fruit fly species viz., Bactrocera dorsalis (Hendel), Bactrocera correcta (Bezzi) and Bactrocera zonata (Saunders) of mango from 10 geographical locations in India using well established degree day approaches. Daily minimum and maximum temperature data were generated by using seven General Circulation Models (GCMs) along with their ensemble, in conjunction with the four representative concentration pathways (RCPs) scenarios (RCP 2.6, RCP 4.5, RCP 6.0 and RCP 8.5) and three time periods (2020, 2050 and 2080) generated from MarkSim® DSSAT weather file generator. Historical data from 1969–2005 of these 10 locations were considered as baseline period. Under future predicted climates, model outputs indicates that all three fruit fly species will produce higher number of generations (1–2 additional generations) with 15–24% reduced generation time over the baseline period. The increased voltinism of fruit fly species due to increased temperature may lead to ≃5% higher infestation of mango fruits in India by the year 2050. Analysis of variance revealed that ‘geographical locations’ explained 77% of the total variation in voltinism followed by ‘time periods’ (11%). Such increase in the voltinism of fruit flies and the consequent increases in the infestation of mango fruits are likely to have significant negative impacts on mango protection and production.

Characterization of liver specific promoters in a foamy viral vector pMD09

Foamy viruses (FVs) or spumaviruses are retroviruses that are explored as vectors for gene therapy. The good feature of foamy viruses is its broad tropism; however, their infections result in non-targeted gene expression. Here, we attempted to design the liver targeted viral gene delivery by employing liver specific gene promoters like albumin (ALB), transthyretin (TTR) and hepatitis B virus (HBV) promoters. We compared the relative gene expression of liver specific promoters versus the U3 promoter in liver cell line (HepG2) and non-liver cell lines: human fibrosarcoma cell line (HT1080), baby hamster kidney cell line (BHK), human embryonic kidney cell line (HEK 293T) and cervical cancer cell line (HeLa). We have found that the promoter exchange didn't affect viral assembly. The ability to drive gene expression was best with TTR promoter which was followed by HBV and ALB promoter. The use of TTR, HBV and ALB promoters are helpful in achieving liver specific gene expression. Keywords: foamy virus; gene therapy; liver; albumin; transthyretin promoter; HBV promoter.

Relationship between body mass index and percentage of body fat, estimated by bio-electrical impedance among adult females in a rural community of North India: A cross-sectional study

Introduction:

Body adiposity measured by percentage of body fat (BF%) is found to be better predictor of cardiovascular morbidity and mortality than body mass index (BMI). Limited information exists showing relationship between BMI and BF% in North Indian population.

Objectives:

To study the relationship between BMI and BF% among North Indian adult females across various age strata and level of BMI.

Materials and Methods:

This was a cross-sectional study conducted at Ballabgarh Health and Demographic Surveillance Site (HDSS) among randomly selected females. BMI using standard techniques and BF% using bioelectrical impedance analysis was estimated. Linear regression was performed using general linear model with BF% as dependent variable and BMI as main independent variable.

Results:

Mean (±2 SD) age of participants was 41.3 ± 15.7 years. Mean BMI (±SD) was 23.3 (±4.6) kg/m², whereas mean fat mass (±2 SD) and BF% (±95% CI) was 19.2 (±7.9) kg and 33.6 (±6.9) %. BMI and BF% were highly correlated among obese (r = 0.77), whereas least correlated (r = 0.32) in underweight females. Across age strata, correlation between BMI and BF% was maximum in 18–35 years age group (r = 0.95), whereas least in females ≥56 years (r = 0.67). Age and BMI together predicted 73% of variability in BF% in hierarchical linear regression model.

Conclusions:

In this population, we have found strong correlation between BMI and BF% particularly at higher level of BMI and in younger females. There is need to conduct more robust prospective longitudinal studies to assess BF%, which is a better predictor of cardiovascular morbidity and mortality.

Energy auditing and carbon footprint under long-term conservation agriculture-based intensive maize systems with diverse inorganic nitrogen management options

A greater energy grant in diesel-fed machinery driven farming substantiate the higher GHGs emission along with improper input (fertilizer, pesticide and irrigation) use and intensive soil management. Practicing conservation tillage, residue retention and diversified crop rotations were advocated because of their multiple benefits. Hence we explored the energy requirement and carbon footprint of conservation agriculture (CA) based maize production systems. Coated N fertilizer [sulphur coated urea (SCU) and neem coated urea (NCU)] were compared with unfertilized and uncoated prilled urea (PU) in the scenario of with and without residue retention on permanent beds (PB) under diversified maize systems [MMuMb, maize-mustard-mungbean and MWMb, maize-wheat-mungbean] in search of a sustainable and energy efficient production system with lesser C-footprint. Results of the 4-year study showed that crops planted on permanent bed with crop residue (PB+R) registered 11.7% increase in system productivity compared to PB without residue (PB-R). N management through Neem coated urea (NCU) recorded 2.3 and 10.9% higher system productivity compared with non-coated prilled urea plot under PB-R and PB+R, respectively. MMuMb was marginally superior than MWMb system in terms of cropping sequence yield, profitability, and energy and carbon use efficiency. Crop residue retention in zero tilled PB increased cost of cultivation by 125 and 147 USD/ha in MMuMb and MWMb systems, respectively. The quantified carbon footprint value was higher in MWMb system. In CA-based practices, crop residues management contributed the highest energy input (61.5-68.4%) followed by fertilizer application (17-20%). Among N management practices, neem coated urea (NCU) significantly improved system productivity and profitability in all the residue applied plots compared to un-fertilized and prilled urea (PU) applied plots. Similarly, higher energy output was also observed in NCU treated plots. However, carbon footprint value was higher in PU (268-285 CO₂-e kg/Mg) plots than NCU (259-264 CO₂-e kg/Mg) treated plots. Thus, the study supports and recommends that the CA-based MMuMb system with efficient N management through NCU is an environmentally safe, clean and energy efficient one, hence can reduce carbon footprint, will ensure food security and will mitigate climate change.

Simultaneous detection of Salmonella enterica, Escherichia coli and Listeria monocytogenes in food using a light scattering sensor

AIM

To investigate the use of a light scattering sensor, BActerial Rapid Detection using Optical scattering Technology (BARDOT) coupled with a multipathogen selective medium, Salmonella, Escherichia and Listeria (SEL), for concurrent detection of the three major foodborne pathogens in a single assay.

METHODS AND RESULTS

BARDOT was used to detect and distinguish the three major pathogens, Salmonella enterica, Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes from food based on colony scatter signature patterns on SEL agar (SELA). Multiple strains of three test pathogens were grown on SELA, and BARDOT was used to generate colony scatter image libraries for inclusive (SEL Library) and exclusive (non-SEL Library) bacterial group. These pathogens were further differentiated using the SEL scatter image library. Raw chicken and hotdog samples were artificially inoculated with pathogens (100 CFU per 25 g each), and enriched in SEL broth at 37°C for 18 h and colonies were grown on SELA for 11-22 h before screening with BARDOT. The BARDOT sensor successfully detected and differentiated Salmonella, STEC and Listeria on SELA with high classification accuracy 92-98%, 91-98% and 83-98% positive predictive values (PPV) respectively; whereas the nontarget strains showed only 0-13% PPV. BARDOT-identified colonies were further confirmed by multiplex PCR targeting inlB gene of L. monocytogenes, stx2 of STEC and sefA of S. enterica serovar Enteritidis.

CONCLUSIONS

The results show that BARDOT coupled with SELA can efficiently screen for the presence of three major pathogens simultaneously in a test sample within 29-40 h.

SIGNIFICANCE AND IMPACT OF THE STUDY

This innovative SELA-BARDOT detection platform can reduce turnaround time and economic burden on food industries by offering a label-free, noninvasive on-plate multipathogen screening technology for reducing microbial food safety and public health concerns.

Where is the Perforation ? Rare Complication of Endoscopic Retrograde Cholangio Pancreatography

Perforation is one of the most feared complications of Endoscopic Retrograde Cholangio Pancreatography (ERCP). ERCP has become important method for treating biliary-pancreatic diseases. Perforation related with Endoscopic Retrograde Cholangio Pancreatography is an infrequent, but if happens is a severe complication. Reported incidence of Edoscopic Retrograde Cholangio Pancreatography related perforation is 0.3-6%. Its mortality is as high as 37.5%. In our hospital since 2010 AD, There were 6 Perforations related to Endoscopic Retrograde Cholangio Pancreatography done in 4787 cases. This is a case of Endoscopic Retrograde Cholangio Pancreatography related perforation with no site of perforation recognized during surgical management.

Experimental setup to measure thermal waves generated by X-ray absorption using pyroelectric sensor

Pyroelectric detectors are widely used for infrared radiation detection, whereas these can also be used in the X-ray region. They have multiple advantages when used at synchrotron radiation sources, such as (a) can be used with a white beam (high flux), (b) have a flat spectral response, and (c) can be used both as a detector and as a sample. However, when used in the hard X-ray region, absorption in the detector plays an important role depending upon the thickness of the detector. Hence, the estimation of the responsivity of the detector is important. In this paper, we report an improved experimental setup for the measurement of a pyroelectric signal in the hard X-ray region. The responsivity (V/W) of a pyroelectric detector for absorbed radiation in the hard x-ray region is measured. Measurements of the K-edge x-ray absorption fine structure of 10-μm copper and nickel foils are carried out using a LiTaO₃ pyroelectric detector and compared with the measurements carried out using an ionization chamber as a sensor for the same foils. Absorption spectra near the Ta L_III and L_II edges in LiTaO₃, measured using a LiTaO₃ crystal both as a sample and as a sensor, are also reported in this paper.

Structural, photoluminescence and dielectric investigations of phosphatic shale

In the current study, the structural and spectroscopic properties of phosphatic shale samples obtained from the Atomic Minerals Directorate for Exploration and Research were probed for potential use as a phosphor material. X-ray diffraction and Raman and Fourier transform infrared spectroscopy revealed that the beneficiated phosphatic shale samples were primarily monophasic consisting of fluorapatite [Ca₅ (PO₄ )₃ F, (FAP)] with minor traces of haematite (α-Fe₂ O₃ ) and calcite (CaCO₃ ). Energy dispersive X-ray fluorescence revealed the presence of U, Eu, Dy and Tb in the FAP matrix substituted at Ca(I) and Ca(II) sites of FAP. A reduced optical direct band gap of 4.46 eV was calculated from the Tauc plot. Photoluminescence spectral studies revealed multicolour emissions (red, yellow, green and blue) on ultraviolet light excitation that were attributed to luminescence spectra from rare earth ions Eu³⁺ , Tb³⁺ , U⁴⁺ and U⁶⁺ in the FAP matrix. The overall emissions for the rare earth and actinide-doped FAP were obtained in the cool white region and the corresponding Commission Internationale de l'Eclairage chromaticity coordinates were calculated to be (0.274, 0.317). The corresponding colour correlated temperature obtained was 9342 K. Furthermore, phosphatic shale had a high room temperature dielectric constant of 11 at a frequency of 1 kHz that demonstrated its suitability for use in biological sensors. The study showed that natural phosphatic shale could be a potential material for optical, biological and dielectric applications.