Acute colonic pseudo-obstruction in an infant after retroperitoneal pyeloplasty successfully treated with rectal irrigation

AbstractAcute colonic pseudo-obstruction is frequently observed in adults but is rarely seen in children. The illness has never been reported in infants, who might differ in their reaction to the acute bowel distension and their response to the available management options. This report describes the presentation of acute colonic pseudo-obstruction in an infant after retroperitoneal pyeloplasty and its successful treatment with rectal irrigation

Fuzzy logic control for energy saving in autonomous electric vehicles

Limited battery capacity and excessive battery dimensions have been two major limiting factors in the rapid advancement of electric vehicles. An alternative to increasing battery capacities is to use better: intelligent control techniques which save energy on-board while preserving the performance that will extend the range with the same or even smaller battery capacity and dimensions. In this paper, we present a Type-2 Fuzzy Logic Controller (Type-2 FLC) as the speed controller, acting as the Driver Model Controller (DMC) in Autonomous Electric Vehicles (AEV). The DMC is implemented using realtime control hardware and tested on a scaled down version of a back to back connected brushless DC motor setup where the actual vehicle dynamics are modelled with a Hardware-In-the-Loop (HIL) system. Using the minimization of the Integral Absolute Error (IAE) has been the control design criteria and the performance is compared against Type-1 Fuzzy Logic and Proportional Integral Derivative DMCs. Particle swarm optimization is used in the control design. Comparisons on energy consumption and maximum power demand have been carried out using HIL system for NEDC and ARTEMIS drive cycles. Experimental results show that Type-2 FLC saves energy by a substantial amount while simultaneously achieving the best IAE of the control strategies tested

The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma

Background: Although the role of oral propranolol in treating IH is now well-recognized worldwide, the variation of treatment effectiveness over time and patients adherence have not been documented among Saudi. Objective: To identify the variation of effectiveness over the treatment period and the adherence to treatment of oral propranolol among Saudi children treated for infantile hemangiomas (IH). Patients and methods: Children presented for treatment of problematic IH between February 2012 and September 2015 were recruited in a prospective observational study of oral propranolol at 2 mg/kg/day. Data about patients’ adherence (categorized based compliance with the scheduled visits and treatment administration), lesion comparative response score (based on the relative improvement compared to previous visit) and possible side-effects were collected during follow-up. Treatment was stopped once the lesions failed to show significant improvement. Serial digital photography was used for response and final outcome assessments. Results: Thirty-six cases were enrolled at a median (range) age of 6 (2–55) months. Cases were classified as 19 minor and 17 major, including 10 with ulcerations. Adherence was poor in 12 (33.3%), moderate in 4 (11.1%) and good in 19 (52.8%). Excluding the poorly adherent, the mean duration of treatment and follow up were 6 ± 3.4 and 7 ± 4.6 months, respectively. A mean comparative response score of 1.67 from a maximum of 2 was achieved during the first month of treatment, then gradually diminished reaching 0.19 and 0 at 8 and 10 months respectively. Patients who successfully completed 6 months of treatment (n = 19) were more likely to present with major lesions (68.4% vs. 33.3%, P = 0.047) and at an earlier median age (4 vs. 11 months, P = 0.018). Complete or near complete responses was 47% achieved. All ulcerated lesions healed at a median of 2 (1–4) months. Conclusion: The most dramatic response to treatment appeared during the first month, then progressively diminished toward negligible benefits beyond 8 months. Adherence to treatment can pose a challenge to achieving satisfactory outcomes

Short hospitalization after early intervention in managing grade III pancreatic injuries in children: A possible new trend

The presence of ductal disruption in pancreatic trauma is a major indicator of severity leading to higher morbidities and prolonged hospital stay. However, the adoption of early interventional approach in selected cases of documented grade III pancreatic trauma could result in shorter hospitalization and early recovery. We are describing our approach of early presentation-tailored interventions in managing two consecutive children diagnosed with grade III pancreatic injuries, which constitute the two main ends of the presentations′ spectrum. For the early presenter a spleen preserving distal pancreatectomy was performed, while for the late presenter with large symptomatic pseudocyst endoscopic drainage was attempted. Both early and late presenting children had quick and uneventful recoveries leading to 5 and 6 days of hospitalization, respectively. Both cases continued to be asymptomatic at 4 and 12 months post procedure. In the pseudocyst case, the gastro-cystostomy stents were removed after 10 weeks, and 2.5 months later a completely healed pancreas was demonstrated by magnetic resonance cholangio-pancreatography. Unlike other abdominal solid organ injuries in children, adopting early presentation-tailored intervention can be associated with quicker recovery and short hospitalization for grade III pancreatic injuries. While the series is still small, achieving such remarkable outcomes in two consecutive cases is possible and could set a new trend in managing these injuries in children

A new approach towards the sustainability of urban-rural integration: The development strategy for central villages in the Abbasiya District of Iraq using GIS techniques

The development of rural areas usually has a positive impact on the urban-rural integration. This study explores an innovative approach to stimulate rural development by proposing qualified villages as central villages that can provide basic urban services for their residents and residents of neighboring villages. This approach can contribute to overcoming the various problems that rural areas faced at the social, economic, and environmental levels. It seeks to achieve spatial sustainability of rural areas, representing a new approach by integrating urban development methods to revitalize rural villages. The study analyzed 15 villages in Abbasiya District of AL Kufa City in the Najaf Governorate of Iraq. Based on the GIS techniques and the analysis of urban service indicators (village population, percentage of urban building materials used in villages, distance between village and health centers, distance between village and main roads, nature of economic activity, distance between village and educational institutions, distance between village and drinking water sources, number of communication towers, and distance between village and urban administrative center), this study proposed that Abu Gharb and Albu Ghraib can served as central villages in Abbasiya District in the future. This study establishes a new rural spatial structure to achieve rural sustainable development, improves the development status of rural areas, and provides a theoretical basis for the government and relevant institutions to use urban service indicators achieving rural sustainable development and formulating relevant development policies in Abbasiya District