Melaena with Peutz-Jeghers syndrome: a case report

Introduction: Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction. Case Presentation: We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed. Conclusion: Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences

Cosmological Birefringence: an Astrophysical test of Fundamental Physics

We review the methods used to test for the existence of cosmological birefringence, i.e. a rotation of the plane of linear polarization for electromagnetic radiation traveling over cosmological distances, which might arise in a number of important contexts involving the violation of fundamental physical principles. The main methods use: (1) the radio polarization of radio galaxies and quasars, (2) the ultraviolet polarization of radio galaxies, and (3) the cosmic microwave background polarization. We discuss the main results obtained so far, the advantages and disadvantages of each method, and future prospects.Comment: To appear in the Proceedings of the JENAM 2010 Symposium "From Varying Couplings to Fundamental Physics", held in Lisbon, 6-10 Sept. 201

Distinguishing Various Models of the 125 GeV Boson in Vector Boson Fusion

The hint of a new particle around 125 GeV at the LHC through the decay modes of diphoton and a number of others may point to quite a number of possibilities. While at the LHC the dominant production mechanism for the Higgs boson of the standard model and some other extensions is via the gluon fusion process, the alternative vector boson fusion is more sensitive to electroweak symmetry breaking through the gauge-Higgs couplings and therefore can be used to probe for models beyond the standard model. In this work, using the well known dijet-tagging technique to single out the vector boson fusion mechanism, we investigate its capability to discriminate a number of models that have been suggested to give an enhanced inclusive diphoton production rate, including the standard model Higgs boson, fermiophobic Higgs boson, Randall-Sundrum radion, inert-Higgs-doublet model, two-Higgs-doublet model, and the MSSM. The rates in vector-boson fusion can give more information of the underlying models to help distinguishing among the models.Comment: 31 pages, 3 figures; in this version some wordings are change

Language barrier and its relationship to diabetes and diabetic retinopathy

10.1186/1471-2458-12-781BMC Public Health121

On the status and mechanisms of coastal erosion in Marawila Beach, Sri Lanka

Coastal erosion remains a problem in many developing countries because of a limited understating of erosion mechanisms and management. Sri Lanka is one of the countries that recognized coastal erosion management as a governmental responsibility, in 1984. Nevertheless, erosion mechanisms have not yet been fully understood. We investigate the status and mechanisms of coastal erosion using empirically collected data and various techniques, such as Geographic Information System analysis of satellite images, drone mapping, bathymetric surveys, hindcasting of wind-induced wave climate, questionnaires, and semi-structured interview surveys. We identified wave climate change, reduction in river sand supply, interruptions from previous erosion management measures, and offshore sand mining as potential causes of erosion considering sediment flux and rates of erosion. Erosion of Marawila Beach began during 2005–2010 and has been continuing ever since, due to a lack of integration in the beach and the entire sediment system. It is necessary to identify the long-term, large-scale changes in the sediment system through data collection. This study highlights the importance of an integrated coastal erosion management plan and could facilitate better coastal erosion management in Sri Lanka, as well as in other developing countries

Risk prediction tools for cancer in primary care.

Numerous risk tools are now available, which predict either current or future risk of a cancer diagnosis. In theory, these tools have the potential to improve patient outcomes through enhancing the consistency and quality of clinical decision-making, facilitating equitable and cost-effective distribution of finite resources such as screening tests or preventive interventions, and encouraging behaviour change. These potential uses have been recognised by the National Cancer Institute as an 'area of extraordinary opportunity' and an increasing number of risk prediction models continue to be developed. The data on predictive utility (discrimination and calibration) of these models suggest that some have potential for clinical application; however, the focus on implementation and impact is much more recent and there remains considerable uncertainty about their clinical utility and how to implement them in order to maximise benefits and minimise harms such as over-medicalisation, anxiety and false reassurance. If the potential benefits of risk prediction models are to be realised in clinical practice, further validation of the underlying risk models and research to assess the acceptability, clinical impact and economic implications of incorporating them in practice are needed.This is the final version of the article. It was first available from NPG via http://dx.doi.org/10.1038/bjc.2015.40

Prevalence of Cataract Surgery and Visual Outcomes in Indian Immigrants in Singapore: The Singapore Indian Eye Study

10.1371/journal.pone.0075584PLoS ONE810-POLN

Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty

Background The diagnosis of hip pain after total hip replacement (THR) represents a highly challenging question that is of increasing concern to orthopedic surgeons. This retrospective study assesses bone scintigraphy with Hybrid SPECT/CT for the diagnosis of painful THR in a selected cohort of patients. Methods Bone SPECT/CT datasets of 23 patients (mean age 68.9 years) with a painful hip after THR were evaluated. Selection of the patients required an inconclusive radiograph, normal serum levels of inflammatory parameters (CRP and ESR) or a negative aspiration of the hip joint prior to the examination. The standard of reference was established by an interdisciplinary adjudication-panel using all imaging data and clinical follow-up data (>12 month). Pathological and physiological uptake patterns were defined and applied. Results The cause of pain in this study group could be determined in 18 out of 23 cases. Reasons were aseptic loosening (n = 5), spine-related (n = 5), heterotopic ossification (n = 5), neuronal (n = 1), septic loosening (n = 1) and periprosthetic stress fracture (n = 1). In (n = 5) cases the cause of hip pain could not be identified. SPECT/CT imaging correctly identified the cause of pain in (n = 13) cases, in which the integrated CT-information led to the correct diagnosis in (n = 4) cases, mainly through superior anatomic correlation. Loosening was correctly assessed in all cases with a definite diagnosis. Conclusions SPECT/CT of THA reliably detects or rules out loosening and provides valuable information about heterotopic ossifications. Furthermore differential diagnoses may be detected with a whole-body scan and mechanical or osseous failure is covered by CT- imaging. SPECT/CT holds great potential for imaging-based assessment of painful prostheses