Neutrophil to lymphocyte ratio and serum procalcitonin level as a predictor of spontaneous ureteral stone passage: A prospective study.

BACKGROUND: Ureteric stone is responsible for around 20% of urinary tract stones and among them 70% of these are located in distal portion of the ureter. Stone causing ureter obstruction produce inflammatory changes in ureteric wall and prevent spontaneous passage of stone. The objective of the study is to compare the predictive role of procalcitonin and Neutrophil-to-lymphocyte ratio (NLR) for spontaneous passage of stone. MATERIALS AND METHODOLOGY: Total 150 participants having ureteric stone of 4-8 mm, were included in prospective observational study. The patients were followed up for 4 weeks. Spontaneous Stone Passage (SSP) was confirmed with either the patient collecting the stone during urination or by Non-Contrast CT performed at 4 weeks. Blood samples of the patients were analysed and White blood cells, sedimentation, Neutrophile to Lymphocyte (NLR), procalcitonin level compared to analyse predictors of future SSP. RESULT: The procalcitonin levels of the Spontaneous stone passing SSP (-ve) group (209.05 ± 78.45 pg/ml) were significantly higher than the not passing the SSP (+ve) group (130.76 ± 24.18) (p < 0.001). NLR is significantly higher in the SSP -ve (3.84 ± 0.41) than the SSP +ve (2.18 ± 0.38) group (p < 0.001). In single and multivariate analysis, significant activity was found for procalcitonin in SP +ve group. CONCLUSION: The findings of the study suggests that high level of procalcitonin, and high NLR have a negative effect on passage of stone. So early intervention can be planned to these patients to prevent complications.

Comparison of serum uric acid levels between localised prostate cancer patients and a control group.

AIM: The aim of this study is to find out whether serum uric acid levels in patients with localised prostate cancer differ from patients with lower urinary tract symptoms without carcinoma prostate. MATERIAL AND METHODS: We performed a prospective observational study of 60 patients having age ⩾ 50 years with c/o lower urinary tract symptoms( LUTS) evaluated by digital rectal examination (DRE), prostate-specific antigen (PSA) level and ultrasonography kidney, ureter, bladder (USG KUB) prostate and patients who were suspicious for carcinoma prostate underwent trans rectal ultrasonography (TRUS) biopsy of prostate. Patients with biopsy s/o prostate cancer were evaluated for metastasis and localised cancer patients were considered as CASE group. Patients with negative biopsy and other patients having LUTS were considered as CONTROL group. The age, serum uric acid level, PSA value, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count were measured. Serum uric acid level was compared in both the groups. RESULTS: The mean serum uric acid level was lower in prostate cancer group (4.77 mg/dl) than control group (6.22 mg/dl) that was statistically significant (p < 0.001). The mean PSA value was 7.43 ng/dl in cancer group and 2.72 ng/dl in control group. (p < 0.001). The mean C-reactive protein (CRP) values were 1.32 and 0.45 respectively (p < 0.001), erythrocyte sedimentation rate (ESR) were found 21 and 10.5 respectively (p < 0.001)and total leucocyte counts (TLC) were found 6.450 and 5.120 respectively (p < 0.001). All were statistically significant (p < 0.05). CONCLUSION: The serum uric acid levels measured in localised prostate cancer patients were found to be reduced compared to the control group and inflammatory markers were found to be increased. Decreased levels of serum uric acid and increased levels of inflammatory markers were determined as risk factors for prostate cancer.

From Theory to Practice: A Sustainable Solution to Water Scarcity by Using a Hybrid Solar Distiller with a Heat Exchanger and Aluminum Oxide Nanoparticles.

The study presently conducted focused on analyzing a solar-powered desalination setup that had a double slope. It can recycle blackish water into drinking water with solar energy. Not only does this result in a significant decrease in carbon emissions but it also represents an environmentally beneficial alternative that is particularly suited for arid locations that are lacking of electrical infrastructure. This system was equipped with a PVT system which makes the system self-sustainable and a CPC collector and implemented the use of aluminum oxide (Al2O3) nanoparticles to enhance its energy efficiency. Energy matrices, economic analysis, and life cycle conversion efficiency were evaluated. The study was conducted annually in New Delhi, with input data provided by IMD in Pune, India. MATLAB was used for the analytical calculations. Energy and exergy were utilized to determine the average annual energy output, which was found to be 8.5%. Additionally, the average energy payback time was calculated to be 16.16%, the average energy payback factor was 13.91%, and the average life cycle cost conversion efficiency was 7.15% higher. The proposed system demonstrated superior performance compared to the previous system in terms of annual yield, energy payback time (EPBT), efficiency of life cycle cost (LCCE), and factor of energy payback (EPBF). The hybrid system has the potential to meet the future demand for potable water and become self-sustainable.

The Duration of Intra-abdominal Hypertension and Increased Serum Lactate Level are Important Prognostic Markers in Critically Ill Surgical Patient's Outcome: A Prospective, Observational Study.

AIM: The present study analyzed the clinical significance of duration of intra-abdominal hypertension (IAH) associated with increased serum lactate in critically ill patients with severe sepsis. MATERIALS AND METHODS: Our study was an observational, prospective study carried out in the Surgical Intensive Care Unit (ICU) at J.L.N Medical College, Ajmer, Rajasthan, India. In our study, we included a total of 100 patients and intra-abdominal pressure (IAP) was measured through intravesical route at the time of admission and after 6, 12, 24, 48, and 72 h via a urinary catheter filled with 25 ml of saline. Duration of ICU and hospital stay, need for ventilator support, initiation of enteral feeding, serum lactate level at time of admission and after 48 h, and 30-day mortality were noted as outcomes. RESULTS: In our study, an overall incidence of IAH was 60%. Patients with cardiovascular surgery and renal and pulmonary dysfunction were 93.3%, 55%, and 60%, respectively, at the time of admission and 65%, 10%, and 10%, respectively, after 72 h of admission in the surgical ICU. Nonsurvivors had statistically significant higher IAP and serum lactate levels than survivors. Patients with longer duration of IAH had longer ICU and hospital stay, longer duration of vasopressors and ventilator support, and delayed enteral feeding. CONCLUSION: There is a strong relationship "risk accumulation" between duration of IAH associated with increased serum lactate and organ dysfunction. The duration of IAH was an independent predictor of 30-day mortality. Early recognition and prompt intervention for IAH and severe sepsis are essential to improve the patient outcomes.