Urine Color Research Articles

The applicability of the urine color scale in pediatric urology

To determine the level of agreement between healthcare professionals, patients and their parents/guardians in the interpretation of the urine color scale (UCS) in cases of urinary dysfunction, analyzing the applicability of the scale as a diagnostic tool determining the hydration status. This was a cross-sectional study involving 5-17-year-old patients with lower urinary tract symptoms (LUTS) and enuresis. The study was conducted in a public healthcare referral center for pediatric urology in the Brazilian state of Bahia between October 2019 and March 2020. The Kolmogorov-Smirnov test was used to assess the distribution of the variables. Agreement was assessed using the kappa coefficient and weighted kappa. The z-test was used to determine significant differences between the kappa and weighted kappa. The statistical analysis was conducted using SPSS, version 14, and significance was established at p<0.05. Forty-four patients were included. The kappa value was 32.4% (p=0.000) for the agreement between healthcare professionals and patients, 41.9% (p=0.000) for agreement between healthcare professionals and parents/guardians, and 25.0% (p=0.001) for agreement between patients and parents/guardians. The weighted kappa was 70.6% (p=0.000) for agreement between healthcare professionals and patients, 82.4% (p=0.000) for agreement between healthcare professionals and parents/guardians, and 51.5% (p=0.001) for agreement between patients and parents/guardians. There was a statistically significant difference in kappa values when the healthcare professionals were compared with the other groups. Although there were some inconsistencies in interpretation, the UCS proved to be a useful tool with which to evaluate patients' hydration status.

Hepatitis A virus infection associated with bilateral pleural effusion, ascites, and acalculous cholecystitis in childhood: a case report

BackgroundAcute hepatitis A infection is common among children in developing nations. The clinical presentation in children is usually asymptomatic and anicteric, and it is a self-limiting infection. Rarely, it can be associated with extrahepatic complications such as pleural effusion, acalculous cholecystitis, and ascites.Case presentationAn 8-year-old middle eastern child presented with abdominal pain, jaundice in the sclera, yellowish color of urine, and poor appetite. In the last two days, abdominal distension developed. After conducting diagnostic investigations, the child was diagnosed with HAV hepatitis associated with bilateral pleural effusion, acalculous cholecystitis, and ascites. He was managed conservatively with vitamin K supplementation and supportive parenteral fluids. After 4 days, clinical improvement was observed.ConclusionHepatitis A infections presented with extrahepatic manifestations like pleural effusion, acalculous cholecystitis, and ascites are very rare, especially in children. There have been some reports of these manifestations occurring in isolation, but for them to co-exist to our knowledge, this has only been reported in two cases in the literature, and this is the third case with all these three rare complications being presented simultaneously in a single child. Although HAV infection is an asymptomatic and self-limiting viral disease in childhood, it can manifest with rare extrahepatic complications, so pediatricians should be aware of this rare association to avoid unnecessary investigations.

Seasonal changes in hydration in free-living Japanese children and adolescents.

Changes in hydration status occur throughout the day affecting physiological and behavioural functions. However, little is known about the hydration status of free-living Japanese children and the seasonality of this response. We evaluated hydration status estimated by urine osmolality (Uosm) in 349 children (189 boys and 160 girls, 9.5±2.6 years, range: 6-15 years) upon waking at home and during a single school day in spring (April) and summer (July). Further, we assessed the efficacy of employing self-assessment of urine colour (UC; based on an 8-point scale) by children to monitor their hydration status. Early morning Uosm was greater in the spring (903±220 mOsm L-1; n=326) as compared to summer (800±244 mOsm L-1; n=125) (P=0.003, paired t test, n=104). No differences, however, were observed in Uosm during the school day (P=0.417, paired t test, n=32). While 66% and 50% of children were considered underhydrated (Uosm≥800 mOsm L-1) upon waking in the spring and summer periods, respectively, more children were underhydrated (∼12%) during the school day. Self-reported UC was similar between seasons as assessed in the morning and school day (P≥0.101, paired t test), which differed from the pattern of responses observed with Uosm. We showed that a significant number of Japanese children are likely underhydrated especially in the spring period. Children do not detect seasonal changes in hydration from self-assessed UC, limiting its utility to manage hydration status in children.

Treatment of Achilles tendon rupture in a patient with alkaptonuric ochronosis

The treatment result of a patient with spontaneous rupture of the Achilles tendon and features of diagnosing alkaptonuric ochronosis, a rare disease, are presented, providing doctors beneficial information for the prevention and/or delay of possible complications. On March 8, 2021, at about 20:50, while at his workplace, getting up from his chair from the table, patient K, 52 years old, felt a sharp pain in the lower third of his right shin and was urgently taken to the hospital. He was examined by a traumatologist and was initially diagnosed with rupture of the right Achilles tendon. His right lower limb was immobilized with a plaster splint. On March 11, 2021, he entered the military traumatology and orthopedics clinic of the Kirov Military Medical Academy for surgical treatment. Upon admission, the patient complained of pain in the right lower leg and impaired support function of the right lower limb. Based on complaints, medical history, laboratory results, and instrumental studies, subcutaneous rupture of the right Achilles tendon was diagnosed. On March 12, 2021, anchor suture of the right Achilles tendon was performed. Anesthesia — combined, access: two separate incisions on the posterior surface of the lower third of the right leg and in the area of the calcaneal tubercle, each 5 cm long, intraoperatively revealed a complete subcutaneous rupture of the right Achilles tendon. Notably, the tendon was black in color when cut. The postoperative period proceeded without complications, and postoperative wounds of linear shape in the right Achilles tendon healed by primary intention. No signs of disturbances were observed in peripheral circulation and innervation of the right lower limb. To confirm the diagnosis, a simple laboratory test was performed: a change in the color of urine during the day, after its additional alkalization. The color change is due to the polymerization of homogentisic acid, which is excreted in large quantities in the urine. To verify the diagnosis, a molecular genetic technique was performed: sequencing of the clinically significant HGD gene and encoding the enzyme homogentisate-1,2-dioxygenase, which are mutations that lead to alkaptonuria. The analysis results confirmed the presence of an amino acid substitution at the pGLy161Arg position, indicating pathogenicity. The use of simple methods of additional laboratory diagnostics and molecular genetic analysis enabled the diagnosis of alkaptonuric ochronosis. Thus, characteristic diagnostic signs were damage to the Achilles tendon in combination with the obtained anamnestic, clinical, and laboratory data of alkaptonuria.

A rare variation of common hepatic artery identified during pancreaticoduodenectomy: a case report and literature review from Syria

Introduction: It is common for the liver to be supplied blood by a hepatic artery branching off the coeliac trunk. Occasionally, a replaced common hepatic artery (RCHA), emerges from the superior mesenteric artery (SMA), can supply the liver in 1.5–4.0% of cases. Computed tomography (CT) angiography is a highly accurate method for identifying arterial anomalies, which may remain undetected until the time of surgery, leading to unexpected complications. Case presentation: A 53-year-old male exhibiting symptoms of decreased appetite, weight loss, vomiting, and altered sclera, urine, and stool colour, underwent a contrast-enhanced CT scan revealing biliary tract dilatation and pancreatic abnormalities, leading to a pancreaticoduodenectomy. During the surgery, an uncommon arterial finding—CHA from SMA—was noted. Pancreatic cancer was confirmed. The patient was discharged a week post-surgery without issues, emphasizing perioperative care progress. Discussion: The authors’ study focused on the detection conditions of the same hepatic artery anomaly in eight cases reported between 2017 and 2023. In two of them the anomaly was discovered in cadaver by routine autopsy. In three cases, this variation was identified before the surgery, but in three other cases it wasn’t detected until the surgical procedure. In the authors’ case, due to multiple reasons, the anomaly remained undetectable until the surgery. Conclusion: This study underscores the importance of thorough preoperative evaluation to grasp vascular variations for better patient care. Also, a noteworthy observation in our case is that the surgeon identified an expanded hepatic vessel, prompting further investigation into this anomaly.

Association of Physicians of India Expert Recommendations on Oral Fluid, Electrolytes, and Energy Management during Transition Care and Discharge for Hospitalized Patients with Nondiarrheal Illnesses.

Acute nondiarrheal illnesses (NDIs) involve overt or subclinical dehydration, requiring rehydration and electrolyte repletion. Dehydration is frequently under-recognized and under-managed, both in outpatient departments (OPDs) and inpatient departments (IPDs). Postadmission dehydration is associated with longer hospital stays and higher inhospital mortality rates. Recognizing and understanding dehydration in hospitalized patients is necessary due to the adverse outcomes associated with this condition. In this article, we aimed to develop practical consensus recommendations on the role of oral fluid, electrolyte, and energy (FEE) management in hospitalized patients with FEE deficits in NDI. The modified Delphi consensus methodology was utilized to reach a consensus. A scientific committee comprising eight experts from India formed the panel. Relevant clinical questions within three major domains were formulated for presentation and discussion: (1) burden and factors contributing to dehydration in hospitalized patients; (2) assessment of fluid and electrolyte losses and increased energy requirements in hospitalized patients; and (3) management of FEE deficits in hospitalized patients [at admission, during intravenous (IV) therapy, IV to oral de-escalation, and discharge]. The consensus level was classified into agreement (mean score ≥4), no consensus (mean score <4), and exclusion (mean score <4 after the third round of discussion). The questions that lacked agreement were discussed during the virtual meeting. The experts agreed that the most common factors contributing to dehydration in patients with NDI hospitalized in IPDs include decreased oral fluid intake, increased fluid loss due to the illness, insensible fluid loss, and a lack of awareness among doctors about dehydration, which can result in poor fluid intake. Time constraints, discontinuity of care, lack of awareness of the principles of fluid balance, lack of formal procedures for enforcing hydration schemes, and lack of adequate training are most often barriers to the assessment of hydration status in hospital settings. Experts used hydration biomarkers, such as changes in body weight, serum, or plasma osmolality; fluid intake; and fluid balance charts; along with urine output, frequency, quantity, and color, to determine hydration status in hospital settings. Experts agreed that appropriate FEE supplementation in the form of ready-to-drink (RTD) fluids can restore FEE deficits and shorten the length of hospital stays in hospitalized patients at admission, during de-escalation from IV to oral therapy, and at discharge. RTD electrolyte solutions with known concentrations of electrolytes and energy are good choices to avoid taste fatigue and replenish FEE in hospitalized patients during transition care and at discharge.

Episodic Hyponatremia in Acute Intermittent Porphyria: A Case Report

Background: Acute intermittent porphyria (AIP) is an uncommon, ubiquitously distributed autosomal dominant disorder with low penetrance characterized by decreased enzyme activity of hydroxymethylbilane synthase (HMBS) an enzyme of heme synthesis pathway. It is often an elusive diagnosis due to rarity and non-specific signs and symptoms. Case report: A 28 years old female from Nawalparasi (district in central Nepal) presented with history of recurrent episodes of abdominal pain and vomiting. Her current episode began two weeks before presentation to our center. Abdominal pain was diffuse, colicky in nature without exacerbating or relieving factor. There was no postural or diurnal variation. On examination, there was no tenderness and abdominal examination findings were unremarkable. Her biochemical investigations were unremarkable except for severe hyponatremia (S. Na of 100mmol/L) which was SIADH/SIADH like presentation (Table 1 and Table 2). Severe episodic hyponatremia, port-wine color of urine, gastrointestinal symptoms and previous hospital stay two years back with similar episode of hyponatremia and abdominal pain were valuable clues for suspicion of acute porphyria. On further evaluation, patient was found to have presence of porphyrogenic precursors in urine and diagnosis of acute intermittent porphyria was confirmed. After diagnosis, she was managed conservatively with carbohydrate loading with intravenous dextrose, opioids and pregabalin as analgesics. Her symptoms gradually improved, hyponatremia subsided and was discharged in normal condition. Conclusion: Acute intermittent porphyria has signs and symptoms common to several clinical, neurological, psychiatric and gastroenterological pathologies, which complicate diagnosis. In young patients with hyponatremia (with SIADH –like picture), AIP should be considered in differential diagnosis.

Diuretic Activity of Water Fraction of Avocado (Persea Americana Mill.) Leaves Extract in Rat

Currently available diuretics are not completely free from side effects such as electrolyte imbalance and metabolic alterations. Avocado (Persea americana Mill.) contained many type of bioactive substances that related to diuretics. This study aimed to reveal and verify the effect of water fraction of avocado leaves extract against output of rat urine. Three different doses of leaf extract of avocado prepared i.e., 91.125mg/kg BW, 182.25 mg/kg BW and 364.5 mg/kg BW. The urinary parameters assessed were the urine volume hourly for 6 hours, urine color density and urine pH. The results showed water fraction of avocado at the dose of 182.25 and 364.5 mg/kg significantly increase urine volume in comparison to the negative control. Urine color density scores varied but did not have a dependent manner that follows the dose levels of diuretics given. However all treatments showed no statistical difference in the urine pH. Thus, it can be conclude that the water fraction of avocado leaves extract potentially for diuretic herb without make significant changes on pH.

ACUTE RHABDOMYOLYSIS IN A JUVENILE WITH DENGUE FEVER: A RARE MANIFESTATION BUT BEWARE

Myalgia is a common symptom in patients with Dengue fever. However, acute rhabdomyolysis is a rare manifestation. The precise mechanism of Dengue-associated rhabdomyolysis has not been determined, it is thought likely to be caused by myotoxic cytokines released in response to viral infection, such as TNF and IFN-α. Here we report a case of a 13-year-old boy with Dengue fever, presenting with red urine on day 5 of illness. Together with a decreased platelet count (26 G/L), we initially suspected hematuria but the urinalysis showed no red blood cells. We then thought of rhabdomyolysis causing myoglobinuria, so we ordered diagnostic tests with the following results: CK 1353 U/L, GOT 361 U/L, GPT 90 U/L. The patient was given intravenous fluids and oral oresol to control urine output. Urine color faded and blood CK concentration returned to normal after 13 days. Rhabdomyolysis is rare in dengue fever but requires proper diagnosis and management to prevent acute kidney injury - a life-threatening complication.

Variegate porphyria onset as neurovisceral manifestation and unusual sensory impairment distribution. Case report

Background: Acute hepatic porphyrias are heme metabolism disorders presenting with a broad clinical spectrum, including neurovisceral manifestations. Peripheral neuropathy is one of the most frequent complications in porphyrias and can correspond about 40 % of the neurovisceral manifestations, and it is mainly attributed to the ALA and PBG accumulation neurotoxicity. The hallmark of an acute porphyric attack is an acute motor axonal neuropathy accompanied by autonomic dysfunction. Sensory impairment is infrequent, and when present, it is classically described as the stocking-glove pattern or, more rarely, a “bathing suit” proximal distribution pattern. Objective: To report a variegate porphyria case in a young patient with unusual sensory manifestations. Methods: A 27-year-old man, previously healthy, present in context of possible arbovirus infeccion with severe abdominal pain, followed by dysautonomia due to orthostatic hypotension, change in urine color and, the emergence of sensory impairment in the trunk and proximal region of the four limbs about twenty days from onset. Dysestesia was severe and marked. Results: Positive clinical features and a urinary exposure test to sunlight corroborate in request genetic testing for acute hepatic porphyrias, with a positive mutation of the PPOX gene in heterozygosis. Discussion: Clinical manifestations with initial presentation of severe dysautonomia followed by sensory changes demarcate neurovisceral involvement of variegate porphyria, adopting an "old-bathing-suit costume" sensory pattern throughout its evolution.

Evaluation and Management of Exertional Rhabdomyolysis Following a Spin Class

Exertional rhabdomyolysis (ER) has become prevalent over the last decade after performing spin classes. ER is characterized by the plasma elevation of creatine kinase as a marker of severe muscle damage. This case study highlights a 26-year-old healthy male that suffered from ER after performing their first ever spin class. The acute and chronic management of the ER is described, along with follow-up assessments that tracked the recovery following discharge from the hospital. Symptoms, such as localized swelling with complete loss of mobility and pain disproportionate to soreness, were characteristic in this individual with ER. Examining the concentration of plasma creatine kinase and monitoring urine output and color provided a good measure to determine when to discharge the patient. Management wise, ambulation should be minimized, and complete bed rest is ideal in conjunction with fluid replacement therapy. Although the individual in this case study did not develop compartment syndrome, its occurrence is always a possibility that should be routinely screened for. Lastly, further research is warranted to determine if there are any dietary interventions to promote a steadfast recovery from ER.

Pak Rama’s Education as a Prevention of Dehydration and Non-Communicable Diseases among Workers in Hot Working Environments

Working in a hot environment can disrupt the balance of body temperature so that the body tries hardly to control the heat which can cause a lack of fluids and is called dehydration. Dehydration can affect cognitive performance, causing decreased productivity and increased risk of work accidents, and in the long term can trigger some non-communicable diseases such as hypertension, urinary tract disease, obesity and others. Pak Rama Education (Active Workers Diligently Drink Water) is an educational and empowerment activity for the worker community, especially those who work in hot environments, in an effort to prevent dehydration and non-communicable diseases. The aim of this activity was to increase workers' knowledge about healthy hydration and increase workers' ability to assess hydration status independently. This activity was carried out using the education method about healthy hydration and a demonstration of how to assess hydration status using a urine color chart. Pak Rama's activity was held on 17th November 2022 at PTPN VII Unit Way Berulu South Lampung. The participants were 50 workers consisting of management officers, factory and plantation workers. From the evaluation results, it was found that the average pre-test score of participants was 66.7 and there was an increase of participants' knowledge about healthy hydration which was seen from the increase in the average score on the post-test, namely 86.6. Based on analysis using the Wilcoxon test, it was found that there was a statistically significant difference between average pretest and posttest scores. The results of the assessment of participants' ability to assess hydration status using a urine color chart were also found increase. Pak Rama's education has proven effective in increasing workers' knowledge about healthy hydration and their ability to assess hydration status independently. Keywords: Healthy hydration; worker’s health; Pak Rama education; non-communicable diseases; urine color chart

Influence of vitamins and food on the fluorescence spectrum of human urine.

Fluorescence spectroscopy of human urine is a method with the potential to gain importance as a diagnostic tool in the medical field, e.g.,for measuring Coproporphyrin III (CPIII) as an indicator of cancer and acute types of porphyria. Food can change human urine's color, which could influence the urine fluorescence spectrum and the detection of CPIII in urine. To determine if there is a noticeable influence on the urine fluorescence spectrum or on the detection of CPIII in urine, 16vitamin supplements, and three food items were tested. Such investigation may also prevent false interpretation of measured data. Urine samples were collected before and after (overnight, ca. 8 h) intake of each test substance. Samples were investigated by fluorescence spectrum analysis. At excitation wavelengths from 300to 500 nm and emission wavelengths from 400to 700 nm excitation-emission-matrices were measured. Data obtained from urine before intake were compared to the data from overnight urine. Furthermore, the investigation of any interference with the CPIII concentration was performed at an excitation wavelength of 407 ± 3 nm and emission wavelengths of 490-800 nm. Only vitamin B2, but none of the other tested substances, showed noticeable influence on the urine fluorescence spectrum. None of the tested substances showed noticeable interference with the recovery rate of CPIII. The correct interpretation of measured data by fluorescence spectroscopy is possible with the exception if vitamin B2 supplementation was performed; thus, the consumption of vitamin B2 supplements before fluorescence testing of the patient's urine should be avoided and/or must be requested. CPIII concentrations could reliably be measured in all cases.

Gaps in kidney stone disease management: From clinical theory to patient reality.

With nephrolithiasis projected to affect 25% of the global population in the next three decades, there is an urgent call for innovative management strategies to prevent and reduce stone recurrence. This study aims to explore the evolving management needs in nephrolithiasis from both patient and healthcare provider perspectives. An expert-collaborative online survey comprising 10 targeted questions on kidney stone management was developed and disseminated. This survey was designed to gather comprehensive insights from patients, physicians and dietician and other person in the field of nephrolithiasis. Analysis of responses from 120 participants, including 45 nephrologists, 38 dieticians, 11 urologists, and 14 kidney stones patients followed in our hospital, revealed critical insights. A significant 97.5% emphasized the necessity of optimizing daily water intake, and 94.1% recognized the need for practical dietary modifications. Additionally, 88.3% of respondents found timely hydration reminders beneficial. Notably, monitoring urine color and pH was valued by 85% and 84.3% of the participants, respectively. A striking disparity emerged in the perception of fatigue and wellness monitoring, with 65% of patients prioritizing fatigue monitoring, a view less shared by healthcare professionals. Similarly, 71% of patients deemed wellness monitoring essential, highlighting a gap in understanding between patients and their caregivers. This study underscores the critical need for more tailored guidance on hydration strategies and the promise of remote urine parameters monitoring in nephrolithiasis management. The findings strongly advocate for a patient-centered approach, aligning medical recommendations with patient lifestyles and experiences, to enhance the effectiveness of nephrolithiasis management.

Plasmodium Parasitaemia and Urine Alterations among Pregnant Women Attending Antenatal Care in Aba Metropolis, Abia State, Nigeria.

Malaria presents a huge threat to pregnant women, their foetus, and children below five years. This study is aimed at assessing malaria prevalence, associated clinical symptoms, and urine abnormalities among pregnant women in Aba metropolis, Abia State, Nigeria. A cross-sectional study involving 450 pregnant women purposively selected from nine health care centres was conducted. Data were analysed using SPSS version 26. The overall malaria prevalence rate was 68.4% (n = 308). Age group of 21-25 years had the highest prevalence rate of 20.4% (n = 92) while the least was recorded among the age group of 41-45 years (17 (3.8%)). Pregnant women in their first trimester had the greatest prevalence rate of 28.6% (n = 129), and the least prevalence was recorded among those in their third trimester (7 (15.6%)). The primigravidae were mostly infected at the rate of 27.7% (n = 125) whereas the multigravidae recorded the least prevalence of 85 (18.9%). Participants with secondary education were the most susceptible at the rate of 38.6% (n = 174). The infected participants exhibited significantly higher frequencies of reported fever (p > 0.001, OR 12.881, 95% CI 3.977-41.725) and headaches (p < 0.001, OR 4.688, 95% CI 1.819-12.083). However, cold, cough, body pains, poor appetite, and catarrh showed no significant association with malaria infection at p > 0.05. Participants using long-lasting insecticidal nets (LLINs) showed significantly lower prevalence rate of malaria infection (p < 0.001, OR 2.485, 95% CI 1.619-3.814). Malaria-infected participants showed statistically significant frequencies of proteinuria (p < 0.001, OR 274.14, 95% CI 16.91-4444.0), bilirubinuria (p < 0.001, OR 49.29, 95% CI 11.01-186.34), and urobilinogenuria (p < 0.001, OR 65.16, 95% CI 4.00-1062.40) than those not infected. Ascorbic acid, nitrate, and ketone showed no significant associations with malaria infection at p > 0.005. Infected participants had statistically significant amber and clear urine colour whereas there was no statistically significant difference between the pH levels of urine of the malaria-infected and malaria-noninfected pregnant women.

Blue-green urine in traditional medicine consumption: a case report and review of the literature

BackgroundAbnormal urine discoloration tends to be concerning for the patient and piques the interest of medical professionals. Different factors can arise in cases of urine turning blue or green. We highlight the necessity of obtaining a thorough history of the patient, particularly regarding previous diets and medications leading up to the condition.Case presentationWe present the case of a 63-year-old man who presented to the emergency room due to an inability to urinate 6 h prior with suprapubic discomfort. He had been having trouble urinating for the past 2 months. The urine bag had a blue-green urine color after urethral catheterization. Further questioning revealed traditional medicine consumption prior to admission.ConclusionsConsideration of the patient’s diet, current medications, and any medical conditions or diseases may aid in deducing the causality of urine discoloration. The clinician’s awareness of the effects of certain medications and conditions could have merit in avoiding unnecessary and costly investigations.

Daily habits and kidney stones development rate. Literature review

Introduction: Kidney stones disease is a medical condition when hard deposites made of various minerals and substances form inside kidneys. It may lead to clinical symptoms as severe pain felt in the belly area or side of the back. Also it can radiate and reach testicles, groin area, labia. Other symptoms may include blood in the urine, abnormal color of urine, fever, nausea, vomiting. Because of growing incidence rate- adequate question is how can we protect ourselves from kidney stones development by changing habits.&#x0D; &#x0D; Aim of study: Fundamental aim of study is to demonstrate how daily, routine habits changes may have a huge impact on kidney stones development risk.&#x0D; &#x0D; State of knowledge: There are a lot of confirmed parameters and factors which can lead to kidney stones devolopment. Factors that increase risk of developing kidney stones include: dehydration, diet (meat intake, fruit/vegetables intake, sodium intake), family or personal history, obesity, digestive diseases and surgery, metabolic disorders, urinary track infections, anatomical abnormalities- obstruction of the kidney, calyceal diverticulum, horseshoe kidney, ureterocele. This group includes many modified factors, so lifetime risk of kidney stones depends also on our habits and way of life.&#x0D; &#x0D; Conclusion: There are many modified factors which may lead to this disease and because of that it is crucial to improve patients and whole society awareness about them. By appropriate daily habits changes we can significantly reduce risk of lifetime kidney stone disease development. It is important to know that concrete reports and analyses were made and they demonstrated scientifically proven correlations.

Blood Transfusion as an Adjunct Therapy in a Foal Affected with Trypanosomiasis

Trypanosomiasis is an infectious haemo protozoan disease that affects various domestic, pet, and wild animals. A 9-month-old foal was presented to the Veterinary Clinical Complex of the College of Veterinary Science, Rajendranagar, Hyderabad with a complaint of reduced appetite, red color urine, and rapid loss of weight for a week. Upon physical examination pale conjunctival and buccal mucous membranes were noticed along with a temperature of 97.20 F Auscultation of the heart revealed high intensity heart beats with 72 bpm. A blood smear was prepared from peripheral veins and its examination revealed RBCs with pleomorphism, microcytes and a few RBCs are acanthocytes. Wet film examination revealed vigorously moving spindle-shaped intercellular parasites Further, Giemsa-stain smear examination revealed the presence of intercellular spindle-shaped organisms, which are suggestive of Trypanosoma evansi. A complete blood picture revealed severe anemia, low levels of hemoglobin, and thrombocytosis, monocytosis, and lymphocytosis. Based on these findings, the case was diagnosed as trypanosomosis and the treatment was initiated with Diminazene aceturate at 3.5mg/K, iron Folic acid, and cyanocobalamin, along with blood transfusion to manage anemia. The foal was successfully revived following a blood transfusion.

Machine learning-assisted image label-free smartphone platform for rapid segmentation and robust multi-urinalysis.

This study presents a groundbreaking approach for the early detection of chronic kidney disease (CKD) and other urological disorders through an image-label-free, multi-dipstick identification method, eliminating the need for complex machinery, label libraries, or preset coordinates. Our research successfully identified reaction pads on 187 multi-dipsticks, each with 11 pads, leveraging machine learning algorithms trained on human urine data. This technique aims to surpass traditional colourimetric methods and concentration-colour curve fitting, offering more robust and precise community screening and home monitoring capabilities. The developed algorithms enhance the generalizability of machine learning models by extracting primary colours and correcting urine colours on each reaction pad. This method's cost-effectiveness and portability are significant, as it requires no additional equipment beyond a standard smartphone. The system's performance rivals professional medical equipment without auxiliary lighting or flash under regular indoor light conditions, effectively managing false positives and negatives across various categories with remarkable accuracy. In a controlled experimental setting, we found that random forest algorithms, based on a Bagging strategy and applied in the HSV colour space, showed optimal results in smartphone-assisted urinalysis. This study also introduces a novel urine colour correction method, significantly improving machine learning model performance. Additionally, ISO parameters were identified as crucial factors influencing the accuracy of smartphone-based urinalysis in the absence of additional lighting or optical configurations, highlighting the potential of this technology in low-resource settings.

Detecting Dehydration Based on Urine Color Using Fuzzy Logic Image Processing and Regulating Water Intake with an Automatic Water Pump According to Dehydration Level Using an IoT-Based

Dehydration is a condition where the body lacks the fluids it needs to carry out its functions optimally. Dehydration can cause various health problems, including decreased mental and physical performance, and can even cause death if not treated immediately. Therefore, it is important to be able to detect and treat dehydration early. One way to detect dehydration is through urine color analysis. Urine that is darker than normal can be a sign of dehydration. The classification of dehydration level according to urine color is as follows: 1-2: Hydrated, 3-4: Mildly dehydrated, 5-6: Dehydrated, 7-8: Very dehydrated. This research aims to develop an IoT-based dehydration detection system that can detect the level of dehydration in a person based on urine color and regulate water intake automatically using a water pump. The novelty of this research is the method of integrating drinking water intake with dehydration detection based on real-time urine color based on IoT using the Fuzzy Logic method. The results of this research are used by the Jember State Polytechnic TeFa Nutrition Care Center (NCC) in serving patients. The methodology used in this research is Fuzzy Logic image processing to process urine color data and determine a person's level of dehydration. After carrying out this research, the following conclusions were obtained: Based on the literature study in this research, 8 levels of hydration status according to NSW Health were obtained, then from this literature a method was obtained to measure a person's hydration based on urine color using image processing using the Fuzzy Logic method.