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Horseshoe kidney is a rare congenital anomaly resulting from the fusion of the lower pole leading to medial and caudal deviation of kidneys that pose challenges to successful stone clearance. We evaluated the various patient- and treatment-related factors that can impact successful stone clearance. A total of 34 patients with 36 renal moieties with urolithiasis in horseshoe kidneys from 2015 to 2021 were included with a median age of 38 years (11–56 years). The mean calculus size was 39.27 mm (21–70 mm). Twenty-two patients had left, 10 had right, and 2 had bilateral disease. Twelve patients (33%) had previous interventions done. As per Guy stone score (GSS), 14 patients had grade IV, 16 patients had grade III, and 4 patients had grade II disease. Of these patients, 22 underwent unilateral percutaneous nephrolithotomy (PCNL), 2 underwent bilateral PCNL, 6 had pyelolithotomy, 2 had right nephrectomy, and 2 patients underwent shockwave lithotripsy (SWL). Six patients undergoing pyelolithotomy had complete clearance. In PCNL, infra-costal puncture was done uniformly. Complete clearance was seen in 12 out of 16 with superior calyceal access (75% stone-free rates, SFR), 2 out of 8 with middle calyceal puncture (25% SFR), and both the cases with inferior calyceal puncture (100% SFR). Factors affecting stone clearance are as follows: GSS, i.e., grade < IV vs ≥ IV (71.4 vs 50%, P = 0.42), STONE score < 12 vs ≥ 12 (83.3 vs 28.5%, P = 0.048), stone size < 40 vs ≥ 40 mm (50 vs 71.4%, P = 0.42). Our analysis showed that stone clearance was independent of mode of access, GSS, or stone size, although STONE score was a predictor of successful outcomes in PCNL. [ABSTRACT FROM AUTHOR]

Differentiating obstructive (OA) from non‐obstructive (NOA) azoospermia is clinically important in managing infertile men. Classically, the differentiation has been based on clinical, hormonal and histological analysis. Histological tests are invasive and may miss spermatogenic areas. Seminal fluid can serve as a medium to assess the status of spermatogenesis and presence or absence of certain markers can help diagnosing and differentiating azoospermia. We evaluated the role of cell‐free seminal markers: DDX4, PRM1 and PRM2 in diagnosing and differentiating between OA and NOA and classifying their subtypes. We observed DDX4 was more sensitive for NOA compared with OA. Among various subtypes of NOA, DDX4 positivity was higher in patients with maturation arrest and hypospermatogenesis compared with Sertoli cell only syndrome. PRM1 and PRM2 had very low positivity rate for any meaningful comparison. Seminal cell‐free markers can serve as non‐invasive tests in diagnosing and differentiating etiologies of azoospermia but their validity needs to be proved in long‐term trials with more refined molecular techniques. [ABSTRACT FROM AUTHOR]

Availability of natural fibre, low cost and ease of manufacturing have urged the attention of researchers towards the possibility of reinforcement of natural fibre to improve their mechanical properties and study the extent to which they satisfy the required specifications of good reinforced polymer composite for industrial and structural applications. The chemically treated natural fibre shows better improvement in properties than untreated fibres. The chemically treated natural fibre has improved interfacial adhesion between fibre surface and polymer matrix. Natural fibre reinforcements have shown better results in impact toughness and fatigue strength. This review aims at explaining about the research and development in the improvement in properties of natural fibre reinforced polymer composites along with its application. [ABSTRACT FROM AUTHOR]

Introduction: There is a worldwide increase in the prevalence of obesity among the adolescent population in India from 16.3% in 2001 to 19.3% in 2010. Recent evidence suggests that bariatric surgery leads to resolution of comorbidities and associated long-term complications in adolescent patients with morbid obesity. Aim: The aim of this study is to determine the impact of bariatric surgery on the weight loss and comorbidities of morbidly obese adolescents. Materials and Methods: A retrospective review of the data of 10 adolescent patients, who underwent Laparoscopic Sleeve Gastrectomy at our institute (tertiary care hospital), from July 2009 to July 2016 was carried out. Results: Of the 10 patients, 4 patients had syndromic forms of obesity. The median age was 16.54 years. The median pre-operative weight and height were 112 kg and 154 cm, respectively, with a body mass index of 47.2 kg/m2. There was no intra-operative or post-operative complication except for suspected methylene blue toxicity in one patient which was treated conservatively. Median follow-up period was 1 year (0-5 years). The patients had an increase in excess weight loss (EWL) of 54.5% until the end of 1 year. There was a regain of weight between the 1st and 2nd year, followed by a sustained weight loss achieving 44.8% EWL at 3 years and 60% at the end of 5 years (only two patients followed up at 5 years). Similar results were found in syndromic patients. Among the four diabetic patients, three had complete resolution and one had improvement in diabetes status. Among the three patients with obstructive sleep apnoea, two patients had complete resolution, while one patient had improvement in symptoms. One patient with hypocortisolism improved after surgery with a decrease in the steroid requirement. Among the hypothyroid patients, one patient had a complete resolution, one patient had improvement in hypothyroid status while two patients had no change. Conclusion: Bariatric surgery is effective for morbidly obese adolescents, leading to significant resolutions of comorbid illness. [ABSTRACT FROM AUTHOR]