Enabling and Inducing Oxygen Vacancies in Cobalt Iron Layer Double Hydroxide via Selenization as Precatalysts for Electrocatalytic Hydrogen and Oxygen Evolution Reactions

Production of hydrogen by water electrolysis is an environment-friendly method and comparatively greener than other methods of hydrogen production such as stream reforming carbon, hydrolysis of metal hydride, etc. However, sluggish kinetics of the individual half-cell reactions hinders the large-scale production of hydrogen. To minimize this disadvantage, finding an appropriate, competent, and low-cost catalyst has attracted attention worldwide. Layer double hydroxide (LDH)-based materials are promising candidates for oxygen evolution reaction (OER) but not fruitful and their hydrogen evolution reaction (HER) activity is very poor, due to the lack of ionic conductivity. The inclusion of chalcogenide and generation of inherent oxygen vacancies in the lattice of LDH lead to improvement of both OER and HER activities. The presence of rich oxygen vacancies was confirmed using both the Tauc plot (1.11 eV, vacancy induction) and the photoluminescence study (peak at 426 nm, photoregeneration of oxygen). In this work, we have developed vacancy-enriched, selenized CoFe-LDH by the consequent wet-chemical and hydrothermal routes, respectively, which was used for OER and HER applications in 1 M KOH and 0.5 M H₂SO₄ electrolytes, respectively. For OER, the catalyst required only 251 mV overpotential to reach a 50 mA/cm² current density with a Tafel slope value of 47 mV/dec. For HER, the catalyst demanded only 222 mV overpotential for reaching a 50 mA/cm² current density with a Tafel slope value of 126 mV/dec. Hence, generating oxygen vacancies leads to several advantages from enhancing the exposed active sites to high probability in obtaining electrocatalytically active species and subsequent assistance in oxygen and hydrogen molecule cleavage.

Vanadium-Doped Nickel Cobalt Layered Double Hydroxide: A High-Performance Oxygen Evolution Reaction Electrocatalyst in Alkaline Medium

Vast attention from researchers is being given to the development of suitable oxygen evolution reaction (OER) electrocatalysts via water electrolysis. Being highly abundant, the use of transition-metal-based OER catalysts has been attractive more recently. Among the various transition-metal-based electrocatalysts, the use of layered double hydroxides (LDHs) has gained special attention from researchers owing to their high stability under OER conditions. In this work, we have reported the synthesis of trimetallic NiCoV-LDH via a simple wet-chemical method. The synthesized NiCoV-LDH possesses aggregated sheet-like structures and is screened for OER studies in alkaline medium. In the study of OER activity, the as-prepared catalyst demanded 280 mV overpotential and this was 42 mV less than the overpotential essential for pristine NiCo-LDH. Moreover, doping of a third metal into the NiCo-LDH system might lead to an increase in TOF values by almost three times. Apart from this, the electronic structural evaluation confirms that the doping of V³⁺ into NiCo-LDH could synergistically favor the electron transfer among the metal ions, which in turn increases the activity of the prepared catalyst toward the OER.

Revealing the pH-Universal Electrocatalytic Activity of Co-Doped RuO2 toward the Water Oxidation Reaction

Electrocatalytic water splitting has gained vast attention in recent decades for its role in catalyzing hydrogen production effectively as an alternative to fossil fuels. Moreover, the designing of highly efficient oxygen evolution reaction (OER) electrocatalysts across the universal pH conditions was more challengeable as in harsh anodic potentials, it questions the activity and stability of the concerned catalyst. Generally, geometrical engineering and electronic structural modulation of the catalyst can effectively boost the OER activity. Herein, a Co-doped RuO₂ nanorod material is developed and used as an OER electrocatalyst at different pH conditions. Co-RuO₂ exhibits a lower overpotential value of 238 mV in an alkaline environment (1 M KOH) with a Tafel slope value of 48 mV/dec. On the other hand, in acidic, neutral, and near-neutral environments, it required overpotentials of 328, 453, and 470 mV, respectively, to attain a 10 mA/cm² current density. It is observed that doping of Co into the RuO₂ could synergistically increase the active sites with the enhanced electrophilic nature of Ru⁴⁺ to accelerate OER in all of the pH ranges. This study finds the applicability of earth-abundant-based metals like Co to be used in universal pH conditions with a simple doping technique. Further, it assured the stable nature in all pH electrolytes and needs to be further explored with other metals in the future.

Successful treatment of extensive basidiobolomycosis with oral itraconazole in a child

BACKGROUND

Basidiobolomycosis is a rare chronic subcutaneous infection caused by Basidiobolus ranarum, which is usually treated with potassium iodide. Extensive deforming lesions in children can occur owing to lack of early diagnosis and/or inappropriate treatment.

CASE REPORT

An 8-year-old girl child presented to us with extensive deforming plaque-like lesions over the left thigh and leg with multiple ulcerations of 1 year's duration. Histopathology was suggestive of subcutaneous zygomycosis with Splendore Hoeppli phenomenon. Microscopic examination of the tissue showed branching, sparsely septate fungal hyphae on a 10%KOH mount, and culture yielded Basidiobolus ranarum. The patient was initially treated with potassium iodide for 6 weeks to which only a poor response was observed. Itraconazole therapy resulted in rapid regression of the lesions and complete resolution after 15 weeks of therapy. She continues to be disease-free at 1 year of follow up.

CONCLUSIONS

This case report highlights that in an older child even longstanding extensive basidiobolomycosis can be safely treated with itraconazole. Surgery is not usually necessary in these patients.

Electrospun Cobalt-Incorporated MOF-5 Microfibers as a Promising Electrocatalyst for OER in Alkaline Media

Metal-organic framework (MOF)-based materials have attracted attention in recent times owing to their remarkable properties such as regulatable pore size, high specific surface area, and elasticity in their network topology, geometry, dimension, and chemical functionality. It is believed that the incorporation of a MOF network into a fibrous matrix results in the improvement of the electrocatalytic properties of the material. Herein, we have synthesized a Co-incorporated MOF-5-based fibrous material by a simple wet-chemical method, followed by an electrospinning (ES) process. The as-prepared Co-incorporated MOF-5 microfibers were employed as an electrocatalyst for the oxygen evolution reaction (OER) in 1 M KOH electrolyte. The catalyst demands a lower overpotential of 240 mV to attain a current density of 10 mA/cm² with a lower Tafel slope value of 120 mV/dec along with a charge transfer resistance value of 2.9 Ω from electron impedance spectroscopy (EIS) analysis. From these results, it has been understood that the incorporation of Co metal into the MOF-5 microfibrous network has significantly improved the OER performance, which made them a potential entrant in other energy-related applications also.

Cobalt tungsten oxide hydroxide hydrate (CTOHH) on DNA scaffold: an excellent bi-functional catalyst for oxygen evolution reaction (OER) and aromatic alcohol oxidation

CTOHH-DNA, a newly developed catalyst utilized for both electrocatalytic OER and aromatic alcohol oxidation reaction with excellent activities.

Identification, quantification of bioactive constituents, evaluation of antioxidant and in vivo acute toxicity property from the methanol extract of Vernonia cinerea leaf extract

CONTEXT

Vernonia cinerea (L.) Less [Compositae (Asteraceae)] is used traditionally for several medical purposes such as inflammation, pain, fever, and cancer.

OBJECTIVES

The present study identified the bioactive constituents in the methanol extract of Vernonia cinerea leaf and evaluated its antioxidant activity and acute toxicity.

METHODS

The identification of phytochemicals was accomplished by GC-MS and the major antioxidant phenolic compounds in the extract were quantified by HPTLC analysis. To quantify the essential elements, atomic absorption spectrophotometeric analysis was carried out. Total phenol and flavonoid content was measured by Folin-Ciocalteau reagent and 2% aluminium chloride, respectively.

RESULTS

GC-MS analysis identified the presence of 27 phytoconstituents. The predominant phenolic compound in the extract as quantified by HPTLC was gallic acid (1.92 mg/g) followed by rutin (0.705 mg/g), quercetin (0.173 mg/g), caffeic acid (0.082 mg/g) and ferulic acid (0.033 mg/g). The following elements were quantified: Fe (0.050 ppm), Mn (0.022 ppm), Co (0.0180 ppm), Pb (0.029 ppm), Hg (3.885 ppm) and Se (4.5240 ppm). The antioxidant activity of the extract increased with increasing concentration and the correlation (r²) for all in vitro assays were satisfactory.

CONCLUSIONS

V. cinerea extract has significant (p < 0.05) antiradical activity. Hence, V. cinerea may have potential medicinal value and can be used in the formulation of pharmacological products for degenerative diseases.

Developments in DNA metallization strategies for water splitting electrocatalysis: A review

The biomolecule DNA with the presence of different functionalities found to interact with different kinds of metal ions and show relatively higher stability over a long period of time when optimized appropriately. With the presence of A-T and G-C pairs, sugar moieties, phosphate functional groups and the double-helical structure, it can assemble both cationic and anionic species and forms a perfect metal-DNA self-assembly. Depending upon the aspect ratio of metal-DNA self-assemblies, metal content and their morphological outcomes, they could deliver variance in the catalytic activities. Such differences can be brought out by varying the synthesis reaction parameters focusing on a specific electrocatalytic application. In this review, recent developments in DNA metallization is elaborated first highlighting the underlying interactions between DNA and cationic/anionic species of various metals following which application of metal-DNA assemblies in electrocatalytic water oxidation and reduction are discussed critically. Knowledge provided in this review thus acts as the guide to various DNA metallization strategies and their subsequent application to water electrolysis for hydrogen generation.

Green and sustainable route for oxidative depolymerization of lignin: New platform for fine chemicals and fuels

Depolymerization of lignin biomass to its value-added chemicals and fuels is pivotal for achieving the goals for sustainable society, and therefore has acquired key interest among the researchers worldwide. A number of distinct approaches have evolved in literature for the deconstruction of lignin framework to its mixture of complex constituents in recent decades. Among the existing practices, special attention has been devoted for robust site selective chemical transformation in the complex structural frameworks of lignin. Despite the initial challenges over a period of time, oxidation and oxidative cleavage process of aromatic building blocks of lignin biomass toward the fine chemical synthesis and fuel generation has improved substantially. The development has improved in terms of cost effectiveness, milder reaction conditions, and purity of compound individuals. These aforementioned oxidative protocols mainly involve the breaking of C-C and C-O bonds of complex lignin frameworks. More precisely in the line with environmentally friendly greener approach, the catalytic oxidation/oxidative cleavage reactions have received wide spread interest for their mild and selective nature toward the lignin depolymerization. This mini-review aims to provide an overview of recent developments in the field of oxidative depolymerization of lignin under greener and environmentally benign conditions. Also, these oxidation protocols have been discussed in terms of scalability and recyclability as catalysts for different fields of applications.

Studies on physiochemical modifications on biologically important hydroxyapatite materials and their characterization for medical applications

Crystalline Hydroxyapatite (Ca10 (PO₄)₆(OH)₂) non linear optical crystal plays a major role in biomedical applications. Crystalline Hydroxyapatite was synthesized using natural human bone sample by thermal methods. This Hydroxyapatite was characterized by Fourier Transform infra-red spectroscopy (FTIR), scanning electron microscope, UV-Vis spectroscopy, X-ray diffraction and conductivity studies. It was found that compared to bovine bone, the changes to the molecular structure associated with the mineral (carbonate) and the organic content (collagen) was good. The sintering methods showed that the synthesized Hydroxyapatite has remarkable heat stability up to 750 °C. The XRD and FTIR results showed a high purity of the synthesized HA powders, in terms of the electronic transitions, in UV-Vis which require a certain amount of energy it is proportional to the wavelength absorbed and absorption coefficient, the optical band energy of the natural human bone is found to be 4.65 eV and the electrical conductivity of the bone material is 9.11 × 10^-6 Ω ^-1 cm^-1. Natural bone Hydroxyapatite gives superior results.

Metallic Gold-Incorporated Ni(OH)2 for Enhanced Water Oxidation in an Alkaline Medium: A Simple Wet-Chemical Approach

The development of a highly efficient electrocatalyst for the oxygen evolution reaction (OER) with a lower overpotential and high intrinsic activity is highly challenging owing to its sluggish kinetic behavior. As an alternative to the state-of-the-art OER catalyst, recently, transition-metal-based hydroxide materials have been shown to play important roles for the same. Owing to the high earth abundance of various Ni-based hydroxide and its derivatives, these are known to be highly studied materials for the OER. Herein, we report a simple wet-chemical synthesis of metallic gold-incorporated (by varying the concentration of Au³⁺ ions) Ni(OH)₂ nanosheets as an active and stable electrocatalyst for the OER in 1 M KOH medium. The Au-Ni(OH)₂ (2) catalyst demanded a low overpotential of 288 mV to attain a geometric current density of 10 mA/cm² with a lower Tafel value of 55 mV/dec compared to bare Ni(OH)₂ with a lower mass loading of only 0.1 mg/cm². Tafel slope analysis reveals that the incorporation of metallic gold on the hydroxide surfaces could alter the mechanistic pathways of the overall OER reaction. It has been proposed that the incorporation of metallic gold over the Ni(OH)₂ surfaces led to a change in the electronic structure of the electroactive nickel sites (Jahn-Teller distortion), which favors the OER by electronic aspects.

Modulating the Surface Electronic Structure of Active Ni Sites by Engineering Hierarchical NiFe-LDH/CuS over Cu Foam as an Efficient Electrocatalyst for Water Splitting

Water electrolysis encounters a challenging problem in designing a highly efficient, long durable, non-noble metal-free electrocatalyst for both oxygen evolution reaction (OER) and hydrogen evolution reaction (HER). Here, in our work, a two-step hydrothermal reaction was performed to construct a hierarchal NiFe-layer double hydroxide (LDH)/CuS over copper foam for the overall water splitting reaction. While employed the same as an anode material, the designed heterostructure electrode NiFe-LDH/CuS/Cu exhibits excellent OER performance and it demands 249 mV overpotential to reach a current density of 50 mA cm^-2 with a lower Tafel slope value of 81.84 mV dec^-1. While as a cathode material, the NiFe-LDH/CuS/Cu shows superior HER performance and it demands just 28 mV of overpotential value to reach a current density of 10 mA cm^-2 and a lower Tafel slope value of 95.98 mV dec^-1. Hence, the NiFe-LDH/CuS/Cu outperforms the commercial Pt/C and RuO₂ in terms of activity in HER and OER, respectively. Moreover, when serving as both the cathode and anode catalysts in an electrolyzer for total water splitting, the synthesized electrode only needs a cell potential of 1.55 V versus RHE to reach a current density of 20 mA cm^-2 and long-term durability for 25 h in alkaline media. To study the interfacial electron transfer, Mott-Schottky experiments were performed, representing that the electron is transferred from n-type NiFe-LDH to p-type CuS as a result of creating the p-n junction in NiFe-LDH/CuS/Cu. The formation of this p-n junction allows the LDH layer to be more active toward the OH- adsorption and thereby could allow the OER or HER with a less energy input. This work affords another route to a cost effective, highly efficient catalyst toward producing clean energy across the globe.

Effective Formation of a Mn-ZIF-67 Nanofibrous Network via Electrospinning: An Active Electrocatalyst for OER in Alkaline Medium

Finding the active center in a bimetallic zeolite imidazolate framework (ZIF) is highly crucial for the electrocatalytic oxygen evolution reaction (OER). In the present study, we constructed a bimetallic ZIF system with cobalt and manganese metal ions and subjected it to an electrospinning technique for feasible fiber formation. The obtained nanofibers delivered a lower overpotential value of 302 mV at a benchmarking current density of 10 mA cm^-2 in an electrocatalytic OER study under alkaline conditions. The obtained Tafel slope and charge-transfer resistance values were 125 mV dec^-1 and 4 Ω, respectively. The kinetics of the reaction is mainly attributed from the ratio of metals (Co and Mn) present in the catalyst. Jahn-Teller distortion reveals that the electrocatalytic active center on the Mn-incorporated ZIF-67 nanofibers (Mn-ZIF-67-NFs) was found to be Mn³⁺ along with the Mn²⁺ and Co²⁺ ions on the octahedral and tetrahedral sites, respectively, where Co²⁺ ions tend to suppress the distortion, which is well supported by density functional theory analysis, molecular orbital study, and magnetic studies.

Ruthenium-Doping-Induced Amorphization of VS4 Nanostructures with a Rich Sulfur Vacancy for Enhanced Hydrogen Evolution Reaction in a Neutral Electrolyte Medium

The generation of pure H₂ from a neutral electrolyte solution represents a transformative route with low cost and environmentally friendly nature. However, the complex kinetics of hydrogen evolution reaction (HER) via water electrolysis make its practical application to be difficult. Herein, we have reported Ru-doping-induced formation of VS₄ nanostructures with a rich S vacancy for neutral HER in a 0.2 M phosphate buffer solution. The Ru-doped VS₄ demands an overpotential value of 160 mV at 10 mA/cm² current density with a lower catalyst loading of 0.1 mg/cm², while pristine VS₄ demands a 374 mV overpotential with the same mass loading. 60 hours of chronoamperometric study reveals the excellent stability of Ru-doped VS₄ materials, which is the highest amount of time ever reported for neutral HER. The marginal degradation of a catalyst under a long-term stability study was confirmed through inductively coupled plasma mass spectrometry (ICP-MS) analysis. The introduction of Ru to the VS₄ lattice leads to a 4.35-fold increase in the turnover-frequency values compared to those of bare VS₄ nanostructures. The higher HER activity of S-vacancy-enriched VS₄ materials is thought to originate through effective water adsorption in S vacancy and Ru³⁺ sites followed by the dissociation of a H₂O molecule, and S₂^2- efficiently converts H_ad to H₂. Also, post-HER characterization reveals that the transformation of some Ru³⁺ to Ru⁰ additionally favored the HER by providing a better H adsorption site under a static cathodic potential.

Surface Decoration of DNA-Aided Amorphous Cobalt Hydroxide via Ag+ Ions as Binder-Free Electrodes toward Electrochemical Oxygen Evolution Reaction

Out of various available methods, generation of hydrogen by electrocatalytic water splitting is the most accepted one which consists of two half-cell reactions, viz, oxygen evolution reaction (OER) at the anode and hydrogen evolution reaction at the cathode. OER is a complex four-electron transfer process, and to sustain the spontaneous generation of hydrogen at the cathode, it is urgent to develop some earth-abundant, low-cost electrode materials. Recently, use of cobalt-based hydroxide as the electrode substrate has taken much consideration and has been fabricated over various substrates. Because of various structural disorders, internal resistance, and dependence on the electrode, the binder substrate makes their applications limited. Here, in this work, to remove structural disorder and to increase electrical conductivity, we have incorporated silver ions into amorphous Co(OH)₂, which turns to be a highly active OER electrocatalyst. Also, for the first time, we have developed hydroxide-based materials by using DNA as a stabilizer, and most importantly, using DNA gives an immense opportunity to run long-term OER applications without using an external binder such as nafion. Moreover, for the first time, these DNA-based materials were coated on nickel foam mainly to eliminate the low conductive nature of Ag₂O. The synthesized catalyst showed a very high OER activity, and to reach 50 mA/cm² current density, it needs only 260 mV as overpotential. The amorphous nature of hydroxide-based materials gives a higher opportunity toward the electrolyte to bind on the surface of a catalyst to run the OER with less applied overpotentials.

Advancing the extended roles of 3D transition metal based heterostructures with copious active sites for electrocatalytic water splitting

The replacement of noble metals with alternative electrocatalysts is highly demanded for water splitting. From the exploration of 3D -transition metal based heterostructures, engineering at the nano-level brought more enhancements in active sites with reduced overpotentials for both the oxygen evolution reaction (OER) and hydrogen evolution reaction (HER). However, recent developments in 3D transition metal based heterostructures like direct growth on external substrates (Ni foam, Cu foam) gave highly impressive activities and stabilities. Research needs to be focused on how the active sites can be enhanced further with 3D heterostructures of transition metals by studying them with various counterparts like hydroxides, layered double hydroxides and phosphides for empowering both OER and HER applications. This perspective covers the way to enlarge the utilization of 3D heterostructures successfully in terms of reduced overpotentials, highly exposed active sites, increased electrical conductivity, porosity and high-rate activity. From the various approaches of growth of transition metal based 3D heterostructures, it is easy to fine tune the active sites to have a viable production of hydrogen with less applied energy input. Overall, this perspective outlines a direction to increase the number of active sites on 3D transition metal based heterostructures by growing on 3D foams for enhanced water splitting applications.

Enhancement of the OER Kinetics of the Less-Explored α-MnO2 via Nickel Doping Approaches in Alkaline Medium

Development of a low-cost transition metal-based catalyst for water splitting is of prime importance for generating green hydrogen on an industrial scale. Recently, various transition metal-based oxides, hydroxides, sulfides, and other chalcogenide-based materials have been synthesized for developing a suitable anode material for the oxygen evolution reaction (OER). Among the various transition metal-based catalysts, their oxides have received much consideration for OER, especially in lower pH condition, and MnO₂ is one of the oxides that have widely been used for the same. The large variation in the structural disorder of MnO₂ and internal resistance at the electrode-electrolyte interfaces have limited its large-scale application. By considering the above limitations of MnO₂, here in this work, we have designed Ni-doped MnO₂ via a simple wet-chemical synthetic route, which has been successfully applied for OER application in 0.1 M KOH solution. Doping of various quantities of Ni into the MnO₂ lattices improved the OER properties, and for achieving 10 mA/cm² current density, the Ni-doped MnO₂ containing 0.02 M of Ni²⁺ ions (coined as MnO₂-Ni_0.002(M)) demands only 445 mV overpotential, whereas the bare MnO₂ required 610 mV overpotential. It has been proposed that the incorporation of nickel ions into the MnO₂ lattices leads to an electron transfer from the Ni³⁺ ions to Mn⁴⁺, which in turn facilitates the Jahn-Teller distortion in the Mn-O octahedral unit. This electron transfer and the creation of a structural disorder in the Mn sites result in the improvization of the OER properties of the MnO₂ materials.

Intervening Bismuth Tungstate with DNA Chain Assemblies: A Perception toward Feedstock Conversion via Photoelectrocatalytic Water Splitting

An advanced approach with DNA-mediated bismuth tungstate (Bi₂WO₆) one-dimensional (1-D) nanochain assemblies for hydrogen production with 5-fold enhanced photoelectrochemical (PEC) water splitting reaction is presented. The creation of new surface states upon DNA modification mediates the electron transfer in a facile manner for a better PEC process. The UV-Vis-DRS analysis results a red shift in the optical absorption phenomenon with the interference of DNA modification on Bi₂WO₆, and, thus, the band gap was tuned from 3.05 eV to 2.71 eV. The applied bias photon-to-current efficiency (ABPE) was calculated and shows a maximum for the Bi₂WO₆@DNA-2 (25.22 × 10^-4%), compared to pristine Bi₂WO₆ (7.76 × 10^-4%). Furthermore, the idea of practical utility of produced hydrogen from PEC is established for the first time with photocatalytic feedstock conversion to platform chemicals using cinnamaldehyde, 2-hydroxy-1-phenylethanone, and 2-(3-methoxyphenoxy)-1-phenylethanone in large scale by hydrogenation and/or hydrogenolysis reactions under eco-friendly green conditions with external hydrogen pressure in an aqueous mixture. Also, the recyclability experiment delivered good yields, which further confirm the robustness of the developed catalyst.

Temperature-Controlled Structural Variations of Meticulous Fibrous Networks of NiFe-Polymeric Zeolite Imidazolate Frameworks for Enhanced Performance in Electrocatalytic Water-Splitting Reactions

Developing non-noble, earth-ample, and stable electrocatalysts are highly anticipated in oxygen-evolution reaction (OER) and hydrogen-evolution reaction (HER) at unique pH conditions. Herein, we have synthesized bimetallic (nickel and iron) zeolite imidazolate framework (ZIF)-based nanofibrous materials via a simple electrospinning (ES) process. The structural stability of the fibrous material is subjected to various calcination conditions. We have elaborated the structural importance of the one-dimensional (1D) fibrous materials in electrocatalytic water-splitting reactions. As a result, NiFe-ZIF-NFs (Nanofibers)-RT (Room Temperature) have delivered a small overpotential of 241 mV at 10 mA cm^-2 current density in OER and 290 mV at a fixed current density of 50 mA cm^-2 in HER at two different pH conditions with 1 M KOH and 0.5 M H₂SO₄, respectively. Furthermore, it exposes the actual surface area of 27.270 m² g^-1 and a high electrochemical active surface area (ECSA) of 50 μF in OER and 55 μF in HER, which is responsible for the electrochemical performance with better stability. This exceptional activity of the materials is mainly attributed to the structural dependency of the fibrous network through the polymeric architecture.

Utility of Urinary Biomarkers Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 as a Marker for Diagnosing the Presence of Renal Scar in Children with Vesicoureteral Reflux (VUR): A Cross-Sectional Study

AIM

To explore the possibility of using urinary biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assess the presence of renal scars in children with Vesicoureteric Reflux (VUR).

MATERIALS AND METHODS

This cross-sectional study was conducted in 94 children aged 0-16 years diagnosed with VUR in the Department of Pediatric Surgery, JIPMER. Urinary biomarkers were measured using the enzyme-linked immunosorbent assay kits, normalized with urinary creatinine (Cr) and compared with severity of VUR (low grade [I and II] and high grade [III, IV, and V]), presence or absence of renal scar in VUR patients and severity of renal scar. Independent Student's t-test, Mann-Whitney U-test, and analysis of variance Kruskal-Wallis test were used for comparison, and receiver operating characteristic (ROC) curve analysis for predicting the accuracy of biomarkers in detecting the presence of renal scars.

RESULTS

The median urinary NGAL (uNGAL) value was higher in children with renal scar (1.49 ng/mL) than those without renal scar (0.58 ng/mL) and was statistically significant (<0.001). Whereas median uNGAL/Cr was higher in children with renal scar (0.07) than those without renal scar (0.03) but was not statistically significant (P = 0.06). Urinary KIM-1 and urinary KIM-1/urinary Cr (uKIM-1/Cr) was not found to be a significant predictor of renal scar. The difference of uNGAL/Cr was comparable between the grades of renal scar but was not statistically significant. On ROC curve analysis, uNGAL had area under the ROC curve (AUC) of 0.769 with 71% of both specificity and sensitivity, whereas uNGAL/Cr was found to be a poor predictor of renal scar with AUC of 0.611, 60% sensitivity, and 61.2% specificity.

CONCLUSION

uNGAL can serve as a noninvasive marker for diagnosing the presence of renal scar in children with VUR and a multicentric more extensive cohort study may be needed to strengthen or negate its role.

Y-type urethral duplication: an unusual variant of a rare anomaly

Urethral duplications are rare anomalies. We present a 3-year-old continent boy passing urine since birth per anus while voiding from penis. Micturating cystourethrogram, retrograde urethrogram and cystoscopy revealed a Y connection between the posterior urethra and anal canal. The accessory channel was excised by a perineal approach. Histopathology revealed that the tract was lined by transitional epithelium, proving that it was indeed a case of urethral duplication; hence, we suggest that all urethroanal fistulas are not variants of anorectal malformations. Certain of these fistulas should be considered as variants of Y-type urethral duplication even if the orthotopic urethra is normal.