Large B- Cell lymphoma presenting as acute abdominal pain and spontaneous splenic rupture; A case report and review of relevant literature

BACKGROUND: Spontaneous rupture of the spleen is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patients survival. Infections have been cited in most cases involving splenic rupture but are rare in hematological malignancies despite frequent involvement of the spleen. METHODS AND MATERIALS: We present a case of a splenic rupture caused by infiltration of B-cell lymphoma. A 43 year old gentleman presented with a 1 day h/o left upper quadrant pain; nausea and vomiting for 2 days with associated dizziness and anorexia. The CT showed abnormal spleen 20 × 11 cm with free fluid in the abdomen and enlarged retroperitoneal LNs. The patient underwent a splenectomy after initial resuscitation and the operative finding was that of a massively enlarged spleen with areas of tumor extruding through the splenic capsule. RESULT AND CONCLUSION: Although the spleen is often involved in hematological malignancies, splenic rupture is an infrequent occurrence. In a recent literature review 136 cases were of splenic rupture secondary to hematological malignancy were identified. Acute leukemia and non Hodgkin lymphoma were the frequent causes followed by chronic myelogeneous leukemia. Male sex, adulthood, severe splenomegaly and cytoreductive chemotherapy were factors more often associated with splenic rupture. Emergency splenectomy remains the cornerstone treatment for splenic rupture. We present a case report of a "spontaneous splenic rupture" and discuss the presentation, etiology and treatment options along with discussion of relevant literatur

Structural variability of 4f and 5f thiocyanate complexes and dissociation of uranium(III)–thiocyanate bonds with increased ionicity

A series of complexes [Et4N][Ln(NCS)4(H2O)4] (Ln = Pr, Tb, Dy, Ho, Yb) have been structurally characterized, all showing the same structure, namely a distorted square antiprismatic coordination geometry, and the Ln–O and Ln–N bond lengths following the expected lanthanide contraction. When the counterion is Cs+, a different structural motif is observed and the eight-coordinate complex Cs5[Nd(NCS)8] isolated. The thorium compounds [Me4N]4[Th(NCS)7(NO3)] and [Me4N]4[Th(NCS)6(NO3)2] have been characterized, and high coordination numbers are also observed. Finally, attempts to synthesize a U(III) thiocyanate compound has been unsuccessful; from the reaction mixture, a heterocycle formed by condensation of five MeCN solvent molecules, possibly promoted by U(III), was isolated and structurally characterized. To rationalize the inability to isolate U(III) thiocyanate compounds, thin-layer cyclic voltammetry and IR spectroelectrochemistry have been utilized to explore the cathodic behavior of [Et4N]4[U(NCS)8] and [Et4N][U(NCS)5(bipy)2] along with a related uranyl compound [Et4N]3[UO2(NCS)5]. In all examples, the reduction triggers a rapid dissociation of [NCS]− ions and decomposition. Interestingly, the oxidation chemistry of [Et4N]3[UO2(NCS)5] in the presence of bipy gives the U(IV) compound [Et4N]4[U(NCS)8], an unusual example of a ligand-based oxidation triggering a metal-based reduction. The experimental results have been augmented by a computational investigation, concluding that the U(III)–NCS bond is more ionic than the U(IV)–NCS bond

Case Report An Elusive Bullet in the Gastrointestinal Tract: A Rare Case of Bullet Embolism in the Gastrointestinal Tract and a Review of Relevant Literature

Bullet embolism within the gastrointestinal system is extremely rare. Such bullet injuries are infrequently covered in the general literature, but the surgeon should be aware of the phenomenon. Smaller caliber bullets are more common in civilian gunshot wound (GSW) events. These bullets are able to tumble through the gastrointestinal tract and cause perforation of the intestinal lumen which is small enough to be easily missed. Bullets retained in the abdominal cavity should not be dismissed as fixed and should be carefully monitored to ensure that they do not embolize within the bowel and cause occult lesions during their migration. We present a unique case wherein a bullet caused a minute perforation in the small bowel, before migrating to the distal colon, which resulted in late presentation of sepsis secondary to peritonitis

Deep Learning Algorithms for Efficient Analysis of ECG Signals to Detect Heart Disorders

Electrocardiography (ECG) has been a reliable method for monitoring the proper functioning of the cardiovascular system for decades. Recently, there has been a lot of research focusing on accurately analyzing the heart condition through ECG. In recent days, numerous attempts are being made to analyze these signals using deep learning algorithms, including the implementation of artificial neural networks like convolutional neural networks, recurrent neural networks, and the like. In this context, this chapter intends to present some important techniques for classifying heartbeats based on deep neural networks with 1D CNN. Five ECG signals (N, S, V, F, and Q) standardization are based on the AAMI EC57 standard. The primary focus of this chapter is to discuss the techniques to classify ECG signals in those classes with promising accuracy and draw a clear picture of the current state-of-the-art in this sphere of study

Dyslipidemia in pre- and post-menopausal women: a study of peri-urban Paundra Kshatriya women

Dyslipidemia is an important risk factor of cardiovascular disease, whereas menopause is a decrease in ovarian follicular activity at the end of reproductive age of the women, which is significantly influenced by hormonal changes brought on by menopause’s impact on serum lipids. This study was undertaken among pre- and post-menopausal Paundra Kshatriya women in Sonarpur, South 24 Parganas, West Bengal, India in order to determine the prevalence of dyslipidemia. 142 adult Paundra Kshatriya women (n pre-menopausal women = 96; n post-menopausal women = 46) were selected from a peri-urban setting of Sonarpur, South 24 Parganas, West Bengal. Anthropometry and arterial pressure data were recorded. Blood samples were collected from study participants who were on 12 hours fasting. 19.79% of pre-menopausal women and 17.39% of post-menopausal women had normal levels of lipids. Prevalence of dyslipidemia was slightly higher (82.7%) among the post-menopausal women compared to pre-menopausal women (80.2%). While high LDL cholesterol emerged as one of the prime causes for dyslipidemia among pre-menopausal women, hypercholesterolemia emerged as one of the prime causes for dyslipidemia among post-menopausal women. Regression analysis revealed a significant impact of 3 factors in pre-menopausal women and impact of 6 factors in post-menopausal women. Though Paundra Kshatriya women maintain a relatively less stressful and high physical activity lifestyle, they exhibited high levels of lipid abnormalities. The peri-urban population is undergoing lifestyle and dietary changes due to a close proximity to the urban centre, Kolkata. FundingAnthropological Survey of India, Ministry of Culture, Government of Indi

On the Selection of Tuning Methodology of FOPID Controllers for the Control of Higher Order Processes

In this paper, a comparative study is done on the time and frequency domain tuning strategies for fractional order (FO) PID controllers to handle higher order processes. A new fractional order template for reduced parameter modeling of stable minimum/non-minimum phase higher order processes is introduced and its advantage in frequency domain tuning of FOPID controllers is also presented. The time domain optimal tuning of FOPID controllers have also been carried out to handle these higher order processes by performing optimization with various integral performance indices. The paper highlights on the practical control system implementation issues like flexibility of online autotuning, reduced control signal and actuator size, capability of measurement noise filtration, load disturbance suppression, robustness against parameter uncertainties etc. in light of the above tuning methodologies.Comment: 27 pages, 10 figure