Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient

AbstractIntroductionHemorrhage is the most common cause of shock in injured patients. Bleeding into the subcutaneous plane is underestimated cause of hypovolemic shock.Presentation of caseUnrestrained male driver involved in a rollover car crash. On examination, his pulse rate was 144bpm, blood pressure 80/30mmHg, and GCS was 7/15. His right pupil was dilated but reactive. Back examination revealed severe contusion with friction burns and lacerations. A Focused Assessment Sonography for Trauma (FAST) was performed. No free intraperitoneal fluid was detected. CT scan of the brain has shown right temporo-parietal subdural hematoma and extensive hematoma in the deep subcutaneous soft tissues of the back. Decompressive cranicotomy and evacuation of the subdural hematoma was performed. On the 4th postoperative day, three liters of dark brown altered blood was drained from the subcutaneous plane.DiscussionThe patient developed severe hypovolemic shock and our aim was to identify and control the source of bleeding during the resuscitation. The source of bleeding was not obvious. Severe shearing force in blunt trauma causes separation between the loose subcutaneous tissues and the underlying relatively immobile deep fascia. This is known as post-traumatic closed degloving injury. To our knowledge this is the first reported case in the English Literature with severe subcutaneous hemorrhage in blunt trauma patients without any previous medical disease.ConclusionBleeding into the subcutaneous plane in closed degloving injury can cause severe hypovolemic shock. It is important for the clinicians managing trauma patients to be aware this serious injury

LISTERIA MONOCYTOGENESIN RAW MILK AND DAIRY PRODUCTS;OCCURRENCE AND TRIALS FOR THEREDUCTION OF THEIR RESISTANCE TO ANTIBIOTICS.

Listeria monocytogenes is a facultative intracellular pathogen responsible for severe infection in animals and humans. This study aimed to determine the occurrence of Listeriamonocytogenes in 200 samples of raw milk and dairy products marketed in Egypt, with detection the antimicrobial resistance profiles of the isolates for different antimicrobial agents. The synergistic effects of three plant extracts in combination with the used antimicrobials to control resistant L. monocytogenes isolates were assessed, with evaluation of relationship between the antibacterial activity and composition of plant extracts. A total of 5 (2.5%) L. monocytogenes isolates were identified (3 isolates from raw milk and two isolates from kariesh cheese and ice cream, one each). The isolates were sensitive to ciprofloxacin and sulphadimidine, while for amoxicillin and oxytetracycline, were resistant. The higher antimicrobial effects of basil and cinnamon extracts were detected, in addition, low concentrations of them were enough to show synergistic effect with the amoxicillin and oxytetracycline to control resistant isolates, these might be attributable to their chemical compositions. In conclusion, there is need for effectively pasteurized raw milk consumption or usage in the production of dairy products. In addition, the chemical composition of these plant extracts might help in its use to control resistant isolates with appropriate antibiotics without the need for increasing the used dosage doses

Multiplication of Sesamia cretica granulovirus in two homogeneous cell lines

A complete replication of the #Sesamia cretica Granulovirus (ScGV) was obtained in vitro by viral infection, as a first record, in two #Spodoptera cell lines. Sl52 and Sf9. ScGV was multiplied in the two cell lines cultivated and established at 27°C after infection with concentrated purified virions used as inoculum. The presence of virus was detected by a DNA nucleic probe, confirming previous results detected by ELISA test. The observation of ultrathin sections of infected cells indicated that complete granules were present in the cell cytoplasm in a significant amount. Purified suspension of granules was obtained after ultracentrifugation on sucrose gradient. The biological characterization of ScGV was completed by in vitro replication. This important Granulovirus was already used by the authors for microbial control of #S. cretica$ larvae on maize. (Résumé d'auteur

A rare case of an adult traumatic bicycle handlebar hernia: A case report and review of the literature

The term handlebar hernia had been applied to describe the traumatic hernia that result from a handlebar-like blunt objects. The force of the blunt trauma is insufficient to breach the elastic skin, yet, it can cause abdominal wall musculature disruption. Serious intraabdominal injuries can result which may be evident at the time of trauma or may be delayed. Many physicians may misinterpret the irreducible hernia as a hematoma or soft tissues contusion following the trauma.Computed tomography (CT) scan remains the gold standard diagnostic tool for evaluation of those patients. Nevertheless, accurate diagnosis can only be made by repeated, careful physical examination.Herein, we present a rare case of true traumatic bicycle handlebar hernia in an adult lady. She is the first reported case in the literature to be treated conservatively. We also reviewed the literature on true traumatic bicycle handlebar hernia in adult patients. Keywords: Adult, Bicycling, Herni

Threshold based AntNet algorithm for dynamic traffic routing of road networks

Dynamic routing algorithms play an important role in road traffic routing to avoid congestion and to direct vehicles to better routes. AntNet routing algorithms have been applied, extensively and successfully, in data communication network. However, its application for dynamic routing on road networks is still considerably limited. This paper presents a modified version of the AntNet routing algorithm, called “Threshold based AntNet”, that has the ability to efficiently utilize a priori information of dynamic traffic routing, especially, for road networks. The modification exploits the practical and pre-known information for most road traffic networks, namely, the good travel times between sources and destinations. The values of those good travel times are manipulated as threshold values. This approach has proven to conserve tracking of good routes. According to the dynamic nature of the problem, the presented approach guards the agility of rediscovering a good route. Attaining the thresholds (good reported travel times), of a given source to destination route, permits for a better utilization of the computational resources, that, leads to better accommodation for the network changes. The presented algorithm introduces a new type of ants called “check ants”. It assists in preserving good routes and, better yet, exposes and discards the degraded ones. The threshold AntNet algorithm presents a new strategy for updating the routing information, supported by the backward ants

Studies on the Pollinators of Some Medical Plants at Giza Govero-Rate.

It was found that the species of the genus Ptosopis, (Hymenoptra) were the most abundant species in pollinating medical plants at Giza Governorate. During the blooming period of mint, the largest number of pollinating bees was belonging to the genus Prosopis constituting 52.7% of the total pollinators, while it was 35.3% during the blooming period of anis 46% during the flowering period of caraway. Most of genera reached its maximum activity at 1 p.m. When the mean temperature and relative humidity being 26°c. and 39 % except genus Chalicodoma reached its maximum activity at 11 a.m. and 3 p.m. during pollinating of anise and caraway