Is the Cut off Limit of Normal Uric Acid ＆ Calcium in Tropical Countries Different？

Introduction： Nephrolithiasis is quite common in this part of the world.In the metabolic workup Uric acid and Calcium assay are important. Calcium ＆ Uric acid lithiasis accounts for significant number of cases. But, the values given as reference do not seem to apply in tropical countries like India. We tried to analyse the values of Serum Calcium ＆ Uric acid in both normal healthy individuals and those with calculus disease in out patient department. Material and methods： The study was conducted in outpatient department wherein Serum Uric acid, Calcium ＆ Phosphorus levels were assessed in fasting state in all patients irrespective of age and sex in the period Jan. 2010- June 2015. A total of 9887 patients with stone disease were kept in Group A and 8967 patients with other diseases in group B who acted as control, were enrolled for the study. The demographic profile was recorded and associated metabolic disorders were also documented. Patients with associated features of bony pains and gout were also specified. Result： The Uric acid levels in the control group B were quite lower than the reference values in either sex. However, the values were more than 6 mg/dl in nephrolithiasis group A. The S.Calcium levels of control in group B were significantly lower than the reference value and patients with nephrolithiasis in group A also had hypocalcemia. Conclusion： Nephrolithiasis is a metabolic disorder with majority of patients having higher Uric acid levels with hypocalcemia in our population.The normal values in control group is on the lower side of reference value which could be due to variation on account of climatic, dietary and geographical factors. It needs broader studies to redefine reference values of Uric acid and Calcium in tropical countries like India.

Sustainable Integrated Inventory Model for Substitutable Deteriorating Items Considering Both Transport and Industry Carbon Emissions

Sustainable integrated inventory management policy focuses on reducing the environmental impact of the manufacturing and transport sector.This study develops an integrated single-manufacturer single-buyer inventory model for substitutable deteriorating items considering transport and industry carbon emissions.This article categorizes carbon emissions into two parts:direct and indirect emissions.We also assume two mutually substitutable items,and substitution is considered on the buyer's side.If one of the items is out of stock,the demand for that item can be partially satisfied by the stock of the other item;else,demand will be lost.The purpose of this study is to minimize the integrated cost of the supply chain with total carbon emissions produced by industry and transport sectors and to determine the optimal number of deliveries,order level and carbon emission quantity.A solution procedure is developed to find the optimal values of the policy.Numerical experiments and sensitivity analyses are presented to demonstrate the proposed model.