Indexical assessment coupled with a self-organizing map (SOM) and positive matrix factorization (PMF) modeling of toxic metal(loid)s in sediment and water of the aquatic environment provides valuable information from the environmental management perspective. However, in northwest Bangladesh, indexical and modeling assessments of toxic metal(loid)s in surface water and sediment are still rare. Toxic metal(loid)s were measured in sediment and surface water from an urban polluted river (Ichamati) in northwest Bangladesh using an atomic absorption spectrophotometer to assess distribution, pollution levels, sources, and potential environmental risks to the aquatic environment. The mean concentrations (mg/kg) of metal(loid)s in water are as follows: Fe (871) > Mn (382) > Cr (72.4) > Zn (34.2) > Co (20.8) > Pb (17.6) > Ni (16.7) > Ag (14.9) > As (9.0) > Cu (5.63) > Cd (2.65), while in sediment, the concentration follows the order, Fe (18,725) > Mn (551) > Zn (213) > Cu (47.6) > Cr (30.2) > Ni (24.2) > Pb (23.8) > Co (9.61) > As (8.23) > Cd (0.80) > Ag (0.60). All metal concentrations were within standard guideline values except for Cr and Pb for water and Cd, Zn, Cu, Pb, and As for sediment. The outcomes of eco-environmental indices, including contamination and enrichment factors and geoaccumulation index, differed spatially, indicating that most of the sediment sites were moderately to highly polluted by Cd, Zn, and As. Cd and Zn content can trigger ecological risks. The positive matrix factorization (PMF) model recognized three probable sources of sediment, i.e., natural source (49.39%), industrial pollution (19.72%), and agricultural source (30.92%), and three possible sources of water, i.e., geogenic source (45.41%), industrial pollution (22.88%), and industrial point source (31.72%), respectively. SOM analysis identified four spatial patterns, e.g., Fe-Mn-Ag, Cd-Cu, Cr-Pb-As-Ni, and Zn-Co in water and three patterns, e.g., Mn-Co-Ni-Cr, Cd-Cu-Pb-Zn, and As-Fe-Ag in sediment. The spatial distribution of entropy water quality index values shows that the southwestern area possesses "poor" quality water. Overall, the levels of metal(loid) pollution in the investigated river surpassed a critical threshold, which might have serious consequences for the river's aquatic biota and human health in the long run.
Background : Urolithiasis is one of the oldest disease known to human beings and has been documented in ancient Greek. Urolithiasis continues to pose a significant health hazard, causing progressive renal impairment, if left untreated. The etiology of renal insufficiency in patients with nephrolithiasis is multifactorial and includes renal obstruction, urinary infection, frequent surgical interventions, and coexisting medical diseases. The purpose of this study is to assess the change in renal function following removal of kidney stones by Percutaneous Nephrolithotomy (PCNL) in patients with associated impaired renal function. Materials and methods : 50 Patients with renal stone disease with associated impaired renal function who were admitted and underwent PCNL in Urology department were selected as per inclusion and exclusion criteria by purposive sampling. Complete clinical evaluation including history, physical examination, relevant examinations & laboratory investigations were performed. All the patients were treated by PCNL monotherapy with Double J stenting. Mean age was 46.63±11.95 years (Age range: 24-72 years). There were 36 males (72%) & 14 females (28%) & male to female ratio was 2.57:1. Results : In this study, a significant fall in mean serum creatinine (0.5 mg%) was demonstrated following the stone removal. The creatinine value remained unchanged in 12% and improved in 84% patients. In contrast to the improvement of renal function as evident by a decline in the mean serum creatinine values, the mean Glomerular Filtration Rate (GFR) registered a small fall of 1.78 ml/min (Statistically not significant). we have observed that total 12 (24%) patients out of 50 cases experienced different sorts of complications. Conclusion: This study showed that PCNL approach to urolithiasis in patients with impaired renal function significantly improves renal functional status manifested according to the preoperative and postoperative difference of serum creatinine and 99mTc DTPA performance. JCMCTA 2019 ; 30 (2) : 70-74
Back ground: The incidence of renal calculi is rising and more patients are presenting with small renal calculi. The treatment options for renal calculi (d”2 cm) are ESWL, percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). The development of minimal invasive surgery for the treatment of renal calculus has led to an increase in success rates and, at the same time, has decreased the morbidity associated with these treatments. Objective: The study aimed to evaluate outcome of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy in the treatment of upper calyceal stone of d”2 cm in diameter. Methods: 60 Patients with radiopaque upper calyceal stone (d”2 cm) were admitted and underwent RIRS (Group A) & PCNL (Group B) in Urology department as per inclusion and exclusion criteria by purposive sampling (30 patients in each group). Complete clinical evaluation including history, physical examination, relevant examinations & laboratory investigations were performed. Result: Mean age was 37.23±11.59 years (range 18-62years) in group A and 40.10±11.49 (range 18-65 years) in group B. Mean operative time was significantly lower in group A (90.13 +/- 18.79 min) than group B (107.36 +/- 16.4 min) (p <0.05). Mean volume of irrigation fluid used during surgery, mean drop in the postoperative hemoglobin concentration, hospital stay, mean VAS score at 8 hours & 24 hours after operation were significantly lower in RIRS group than PCNL group (p< 0.05). We achieved a stone clearance of 90.00% in the RIRS group and 96.67% in the PCNL group. The difference in stone clearance in two groups was not statistically significant (p=0.30). Conclusion: The study concluded Retrograde intrarenal surgery (RIRS) in the treatment of upper calyceal stone of d”2cm in diameter is a feasible, effective and safe treatment option. Given the added morbidity in PCNL, RIRS should be considered standard therapy in these patients. Bangladesh J. Urol. 2021; 24(1): 99-104
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