Kaushal Kumar

Evaluation of Renal Histopathological Changes, as a Predictor of Recoverability of Renal Function Following Pyeloplasty for Ureteropelvic Junction Obstruction

Background: Pyeloplasty is a widely accepted treatment for ureteropelvic junction obstruction (UPJO). However, the renal function recoverability after pyeloplasty is still a matter of debate. Different parameters have been used to predict renal functional recoverability after corrective surgery, with conflicting results. Objectives: In this study, renal biopsy was carried on a series of cases of UPJO, during pyeloplasty, to study the extent of histological alterations in renal parenchyma, as a result of obstruction, and its predictive value in renal function recoverability after pyeloplasty. Patients and Methods: We retrospectively analyzed the renal biopsy obtained during pyeloplasty in 53 adult patients. Histopathological changes were graded on a scale of 1 to 3, according to their severity, and compared with the differential renal function (DRF) revealed on the preoperative and postoperative follow up diethylene triamine pentaacetic acid (DTPA) renal scan. A Fischer’s t test was used to evaluate statistical differences between values. Results: This study showed a linear relationship between the severity of histological changes and renal function recovery, after pyeloplasty. Out of 24 obstructed renal units (ORU), with minimal histopathological changes (grade I), 21 ORU (87.5%), with > 35% DRF preoperatively, showed significant improvement in renal function after 12 months of pyeloplasty (P < 0.05). On the other hand, all kidneys (n = 29) with moderate to severe obstructive changes (grade II and III) had minimal improvement in DRF, after pyeloplasty, which was clinically insignificant (P > 0.05). Renal function deterioration after pyeloplasty was not observed in any of the cases. Conclusions: The severity of pathological changes in renal parenchyma, due to UPJO, is a good predictor of renal function recoverability, after pyeloplasty. The ORUs, with DRF > 35%, usually have normal (grade I) renal biopsy and might be expected to present better functional recoverability after pyeloplasty.

Bilateral Renal Lymphangiectasia in a Thirty-two-Year-Old Woman.

Introduction: Renal lymphangiectasia is a rare disorder of the lymphatic system that might be confused with various other renal cystic diseases and urinoma. Clinical presentation is non-specific and characteristic findings in radiologic imaging are the mainstay of diagnosis. Case Presentation: We reported a case of bilateral lymphangiectasia in a 32-year-old woman who presented with flank pain and hypertension. Discussion: Renal lymphangiectasia is an uncommon benign condition. Most of the cases improve with conservative treatment. Surgery is rarely required, except in cases such as those with persistent pain refractory to medication.

Chyluria in Pregnancy-A Decade of Experience in a Single Tertiary Care Hospital

Background: Chyluria i.e. passage of chyle in urine, giving it milky appearance, is common in many parts of India but rare in west. Very few case of chyluria in pregnant female has been reported in literature. Persistence of this condition may have deleterious effects on health of child and mother. In the present study 43 cases of chyluria during pregnancy and their management seen over a period more than 10 years have been presented. Objectives: The study aims to present our experience of managing 43 cases with chyluria during pregnancy over a period of ten years from July 2003 to June 2014. Patients and Methods: Forty three pregnant patients with chyluria, who presented between July 2003 to June 2014 to the department of Urology, Indira Gandhi Institute of Medical Sciences, Patna were included. Patients underwent conservative management and/or sclerotherapy after evaluation. Follow-up of all patients was done by observation of urine color, routine examination of urine and test for post prandial chyle in urine up to 3 months after delivery. Results: Conservative management by dietary restriction of fat and physical rest was successful in six patients. Thirteen patients improved after first course of sclerotherapy with 10% povidone iodine and 25% dextrose and 19 patients improve after second session. In non-responders, three patients who were near term underwent caesarian section while two patients opted for medical termination of pregnancy at their own will. After sclerotherapy, minor complications like clot retention, fever, hematuria, and abdominal pain were observed in small number of patients and managed symptomatically. Conclusions: Sclerotherapy for symptomatic relief of chyluria during pregnancy showed high response rate (86.2%) in short term follow-up. Sclerotherapy with 10% povidone iodine and 25% dextrose combination have been proved safe and effective during pregnancy. Medical termination of pregnancy and cesarean section (those near term) may be the options in resistant cases not responding to sclerotherapy.

Herbicides, Nitrogen-Scheduling and –Rates Effects on Economics of Wheat (Triticum aestivum L.)

A field experiments was conducted during winter seasons of 2010–11 and 2011–12 at Agricultural Research Farm, Banaras Hindu University, Varanasi to study the effect of herbicide mixtures and differential rate of nitrogen application of economics of wheat under Indo-Gangetic Plains of eastern Uttar Pradesh. The experiment was laid out in factorial randomized complete block design and replicated thrice, having three factors. First factor comprised of three herbicides viz. weedy check, sulfosulfuron + metsulfuron [32 g ha−1] and carfentrazone [10 g ha−1] + fenoxaprop-p-ethyl [100 g ha−1], whereas, second and third factors comprised of two nitrogen rates (120 kg N ha−1 and 160 kg N ha−1) and three times of nitrogen application (50% basal + 50% CRI, 50% basal + 25% CRI + 25% flowering and 33.3% basal + 33.3% CRI + 33.3% flowering), respectively. Significantly highest grass return, net return and benefit cost ratio were observed with application of sulfosulfuron + metsulfuron [32 g ha−1]. Increasing nitrogen level from 120 to 160 kg ha−1 significantly increased the economic return. Application of nitrogen in three split (50% basal + 25% CRI + 25% flowering) proved significantly in term of grass return, net return and benefit cost ratio over other split application of nitrogen.

An economics of rice cultivation through appropriate management of zinc under northern gangetic alluvial plain

A field experiment was conducted to study the economics of rice cultivation through appropriate management of zinc at Agricultural Research Farm of Institute of Agricultural Sciences, Banaras Hindu University during the two consecutive kharif (rainy) seasons of 2010 and 2011. The experiment was laid out in randomized block design with three rice varieties (HUR-105, HUBR 2–1 and PHB-71) and seven zinc treatments. The hybrid PHB 71 showed the highest gross return of 78007 and 79570, but HUR 105 recorded maximum net return of 46886 and 48180 and B: C ratio 2.58 and 2.63 in year 2010 and 2011, respectively. Amongst the zinc treatments, application of Zn (EDTA) 0.25 kg ha-1 at basal + Zn (EDTA) 0.05% sprays at maximum tillering stage resulted in maximum gross return of 87211 and 88531), net return of 57572 and 58892 and B: C ratio 2.94 and 2.99 and was found economically feasible during both the years of experimentation.

Development of integral bladed rotor using linear optimisation technique

Bladed disks are the most flexible elements in high speed rotating machinery. Stress analysis of these elements present some challenges. These challenges stem from high stress gradients due to contact faces, the non-linearities attending conforming contact with friction. Thermal gradients are also encountered across the disc bore and rim due to uneven temperature distribution. The rim of the disc is made heavier to resist the centrifugal pull of the blade, thus making the assembly heavier. Investigations have been carried out to develop and improve ‘blisks’ which are integrated version of blades and disc, offering significant weight saving. The present paper describes the possible development process of upgrading a general purpose conventional bladed disc of a single stage compressor into blisk, using linear programme, a finite element analysis tool for linear optimisation, as a dedicated ‘design-tool’ keeping the same operating conditions and the allowable design limits through numerical models. Design methodology, burst-failure criteria of blisk and bladed disc are discussed in full length. This tool developed exploits the quick convergence ability of a linear system for handling large iterations and overcomes the limitation imposed by material non-linearity, over-speed and burst margin for all decision points based on stress, strain and displacement, in the design-flow process.