A 37-year-old patient presenting with pneumaturia: a case study

No Abstract

Right abdominal mass: keep an open mind

Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms. Amebomas occur rarely, usually in cecum and ascending colon, when they can masquerade as colon carcinoma. This report describes the case of a 27-year-old male who presented with right abdominal mass. Radiological examination prompted us to the differential diagnosis of ameboma and he was treated with metronidazole and broad-spectrum antibiotics for two weeks. Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass

A Sustainable Water Resources Management Plan for Wadi Hanifa in Saudi Arabia

Wadi Hanifah is one of the major natural landmarks in the middle part of Najd plateau. It represents the natural drain for the surface water of a very wide area. The Wadi passes through the city of Arriyadh and about 70% of the city is located within its catchment area.In the last decade, ground water management programs in the city have contributed to the perennial flow in part of the Wadi between the confluence of Al-Aysan channel in the north to after Al-Hair in the south of the Wadi forming a river in the desert. In addition to that, treated wastewater to the tertiary stage is also discharged into the Wadi. Perennial flow is about 0.4 M mVday and is expected to increase by 3 to 4 folds by 2021.This paper will highlight the importance of Wadi Hanifah to Arriyadh city and shall suggest an integrated water resources management plan for Wadi Hanifah. This plan will provide sustainability to the Wadi utilizing a number of measures. These measures are anticipated to improve flood performance of the Wadi, improve surface water quality and hence protect the quality of groundwater. The plan proposes possible scenarios for water reuse to meet present and future needs of the city

Cost-utility analysis of surgical fixation with Kirschner wire versus casting after fracture of the distal radius

Aims: The aim of this study was to compare the cost- effectiveness of surgical fixation with Kirschner (K-) wire ersus moulded casting after manipulation of a fracture of the distal radius in an operating theatre setting. Methods: An economic evaluation was conducted based on data collected from the Distal Radius Acute Fracture Fixation Trial 2 (DRAFFT2) multicentre randomized controlled trial in the UK. Resource use was collected at three, six, and 12 months post-randomization using trial case report forms and participant-completed questionnaires. Cost-effectiveness was reported in terms of incremental cost per quality-adjusted life year (QALY) gained from an NHS and personal social services perspective. Sensitivity analyses were conducted to examine the robustness of cost-effectiveness estimates, and decision uncertainty was handled using confidence ellipses and cost-effectiveness acceptability curves. Results: In the base case analysis, surgical fixation with K-wire was more expensive (£29.65 (95% confidence interval (CI) -94.85 to 154.15)) and generated lower QALYs (0.007 (95% CI -0.03 to 0.016)) than moulded casting, but this difference was not statistically significant. The probability of K-wire being cost-effective at a £20,000 per QALY cost-effectiveness threshold was 24%. The cost-effectiveness results remained robust in the sensitivity analyses. Conclusion: The findings suggest that surgical fixation with K-wire is unlikely to be a cost-effective alternative to a moulded cast in adults, following manipulation of a fracture of the distal radius in a theatre setting.</p