Intussusception in a 20 weeks pregnant woman: a case report

Intussusception in pregnancy is rare and poses unique diagnostic and therapeutic challenges. We present the case of a 22 year old, 20 weeks pregnant woman who presented with acute abdominal pain. Following abdominal ultrasound scanning she was diagnosed with intussusception. The patient underwent laparotomy and a small bowel resection was performed without any post operative complications. We review the literature to give a concise and up to date summary on the diagnosis and treatment of the condition with particular emphasis on the recently recognised usefulness of ultrasound scanning

Haemobilia causing cholangitis in a patient on dual anti-platelet treatment suffering from acute acalculous cholecystitis

AbstractINTRODUCTIONHaemobilia is a rare cause of upper gastro-intestinal haemorrhage which can be difficult to diagnose.PRESENTATION OF CASEWe present the case of a patient who suffered from acute acalculous cholecystitis while on dual anti-platelet therapy with aspirin and clopidogrel. We describe the diagnostic and treatment challenges arising from the patient's complicated past history and the steps leading to the diagnosis of haemobilia causing biliary obstruction and cholangitis. Our patient did not, at any point, manifest anaemia or evidence of haemorrhage.DISCUSSIONHaemobilia has a varied aetiology. To our knowledge there is no association with dual anti-platelet treatment in the literature to date. Diagnosis is difficult and relies on multiple modalities. In our patient the final diagnosis was only made in the course of open bile duct exploration.CONCLUSIONIn acute biliary obstruction we recommend the consideration of haemobilia in the differential diagnosis, especially in patients with a bleeding tendency

Global Law as Intercontextuality and as Interlegality

Since the 1990s the effects of globalization on law and legal developments has been a central topic of scholarly debate. To date, the debate is however marked by three substantial deficiencies which this chapter seeks to remedy through a reconceptualization of global law as a law of inter-contextuality expressed through inter-legality and materialized through a particular body of legal norms which can be characterized as connectivity norms. The first deficiency is a historical and empirical one. Both critics as well as advocates of ‘non-state law’ share the assumption that ‘law beyond the state’ and related legal norms have gained in centrality when compared with previous historical times. While global law, including both public and private global governance law as well as regional occurrences such as EU law, has undergone profound transformations since the structural transformations which followed the de-colonialization processes of the mid-twentieth century, we do not have more global law relatively to other types of law today than in previous historical times. The second deficiency is a methodological one. The vast majority of scholarship on global law is either of an analytical nature, drawing on insights from philosophy, or empirically observing the existence of global law and the degree of compliance with global legal norms at a given moment in time. While both approaches bring something to the table they remain static approaches incapable of explaining and evaluating the transformation of global law over time. The third deficiency is a conceptual-theoretical one. In most instances, global law is understood as a unitary law producing singular legal norms with a planetary reach, or, alternatively, a radical pluralist perspective is adopted dismissing the existence of singular global norms. Both of these approaches however misapprehend the structural characteristics, function and societal effects of global law. Instead a third positon between unitary and radical pluralist perspectives can be adopted through an understanding of global law and its related legal norms as a de-centred kind of inter-contextual law characterised by inter-legality

TO ERADICATION OF VOLTAGE SAG AND HARMONICS IN DISTRIBUTION SYSTEM USING DVR WITH CAPACITOR COMPENSATION SCHEME

Power Quality (PQ) is that the most vital perspectives on transmission and distribution ranges. The availability of high-grade electric powered offerings wished for the customers illustrates this idea. The voltage sag and swell square degree the most not unusual PQ problems that in particular rise up in the distribution systems because of the truth that it's going to cause tool tripping, failure of stress systems, closure for home and business instrumentality. The Dynamic Voltage Restorer (DVR) associated nonparallel has amazing dynamic talents and is a flexible solution for PQ troubles. Ultra-capacitors (UCAP) have quality developments like excessive strength and espresso electricity density important for the mitigation of voltage sag and swell. This paper offers AN extended DVR topology capable of handing over deep, prolonged mitigation for power terrific troubles. Within the planned DVR, UCAP is employed as strength storage because it offers immoderate electricity in a totally short c software language length of it gradual. The DVR is protected into Ultra capacitor via a bifacial DC-DC converter which facilitates in supplying a rigid dc-link voltage and conjointly enables in compensating transient voltage sag and voltage swell. PI Controller is hired in DVR for electricity exceptional improvement. The simulation model for the proposed device has been superior in MATLAB and therefore the performance over famous DVR is legitimate with the effects obtained

CMEs and SEPs During November-December 2020: A Challenge for Real-Time Space Weather Forecasting

Predictions of coronal mass ejections (CMEs) and solar energetic particles (SEPs) are a central issue in space weather forecasting. In recent years, interest in space weather predictions has expanded to include impacts at other planets beyond Earth as well as spacecraft scattered throughout the heliosphere. In this sense, the scope of space weather science now encompasses the whole heliospheric system, and multipoint measurements of solar transients can provide useful insights and validations for prediction models. In this work, we aim to analyze the whole inner heliospheric context between two eruptive flares that took place in late 2020, that is, the M4.4 flare of 29 November and the C7.4 flare of 7 December. This period is especially interesting because the STEREO-A spacecraft was located similar to ~60 degrees east of the Sun-Earth line, giving us the opportunity to test the capabilities of "predictions at 360 degrees" using remote-sensing observations from the Lagrange L1 and L5 points as input. We simulate the CMEs that were ejected during our period of interest and the SEPs accelerated by their shocks using the WSA-Enlil-SEPMOD modeling chain and four sets of input parameters, forming a "mini-ensemble." We validate our results using in situ observations at six locations, including Earth and Mars. We find that, despite some limitations arising from the models' architecture and assumptions, CMEs and shock-accelerated SEPs can be reasonably studied and forecast in real time at least out to several tens of degrees away from the eruption site using the prediction tools employed here.</p