Skin ulceration as a complication from unexpected extravasation injury: A case report

Extravasation injury (EVI) is common, yet it is always underestimated and underreported. Severity varies ranging from thrombophlebitis up to disability. Unrecognised EVI is a potential medicolegal case in medicine. We experience a 47-year-old lady who developed an unrecognised EVI after being admitted for sepsis. The EVI turned out to be a huge and sloughy skin ulcer. A series of wound debridement with vacuum dressing were conducted until the wound was able to be closed. The EVI can be categorised according to Amjad EVI grading and Loth and Eversmann’s EVI classification. Adult EVI tends to be overlooked, especially during critical care because patients cannot complain upon sedation and ventilation. In order to prevent EVI, firstly prevention is better than cure. Secondly, if EVI is recognised early, infusion should be stopped immediately. Thirdly, analgesia is mandatory. Finally, the plastic team needs to be engaged if it is deemed required. Prevention and early intervention before the occurrence of progressive tissue damage is the key to treatment. Early radical wound debridement and immediate or delayed wound coverage with skin graft or skin flap are indicated in full thickness skin necrosis, persistent pain, and chronic ulcer

Infected omental cyst complicated with subacute intestinal obstruction and ileal erosion in a 2-year-old boy: a case report

An omental cyst is a rare intraabdominal pathology that can cause acute abdomen and intestinal obstruction among children. A 2-year-old boy presented with fever, bilious vomiting, abdomen distension and loose stool of acute onset. The chest and abdominal radiographs showed right pleural effusion and prominent small bowels with thickening walls respectively. Ultrasonography revealed a gastrointestinal duplication cyst. An exploratory laparotomy was done and found a 5x5 cm infected omental cyst, severely adhered to and eroded into the ileum causing a small perforation. Omental cyst excision and ileal primary repair were done. The final diagnosis was a benign omental cyst. Omental cyst is usually asymptomatic; however, symptomatic omental cyst should be cautious for bleeding, intestinal obstruction, infection, torsion and rupture

Unexpected irreducible femoral hernia during elective operation: what is the best surgical approach?

Femoral hernia is rare and commonly presents with incarceration in emergency situations. From the literature review, there is no femoral hernia reported in chronic irreducible presentation. A 44-year-old female, who was planned for an elective hernia surgery for a chronic irreducible inguinal hernia, was discovered to have an irreducible femoral hernia intraoperatively. Herein, we revisit this diagnostic entity, discuss its misdiagnosis and suggest the best surgical approach when such an unexpected situation happens during an operation

Infected omental cyst complicated with subacute intestinal obstruction and ileal erosion in a 2-year-old boy: A case report

An omental cyst is a rare intraabdominal pathology that can cause acute abdomen and intestinal obstruction among children. A 2-year-old boy presented with fever, bilious vomiting, abdomen distension and loose stool of acute onset. The chest and abdominal radiographs showed right pleural effusion and prominent small bowels with thickening walls respectively. Ultrasonography revealed a gastrointestinal duplication cyst. An exploratory laparotomy was done and found a 5x5 cm infected omental cyst, severely adhered to and eroded into the ileum causing a small perforation. Omental cyst excision and ileal primary repair were done. The final diagnosis was a benign omental cyst. Omental cyst is usually asymptomatic; however, symptomatic omental cyst should be cautious for bleeding, intestinal obstruction, infection, torsion and rupture

Synergy study on charge transport dynamics in hybrid organic solar cell: photocurrent mapping and performance analysis under local spectrum

Charge transport dynamics in ZnO based inverted organic solar cell (IOSC) has been characterized with transient photocurrent spectroscopy and localised photocurrent mapping-atomic force microscopy. The value of maximum exciton generation rate was found to vary from 2.6 × 1027 m−3s−1 (Jsat = 79.7 A m−2) to 2.9 × 1027 m−3s−1 (Jsat = 90.8 A m−2) for devices with power conversion efficiency ranging from 2.03 to 2.51%. These results suggest that nanorods served as an excellent electron transporting layer that provides efficient charge transport and enhances IOSC device performance. The photovoltaic performance of OSCs with various growth times of ZnO nanorods have been analysed for a comparison between AM1.5G spectrum and local solar spectrum. The simulated PCE of all devices operating under local spectrum exhibited extensive improvement with the gain of 13.3–13.7% in which the ZnO nanorods grown at 15 min possess the highest PCE under local solar with the value of 2.82%

A rare cause of acute abdomen – Spontaneous rectus sheath hematoma

Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms presentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome

Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management

Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications

Fabrication of piezoelectric polymer multilayers on flexible substrates for energy harvesting

10.1088/0964-1726/23/1/015013Smart Materials and Structures231-SMST

Viable short-term directed energy weapon naval solutions: a systems analysis of current prototypes

With conventional weapons nearing their peak capability, the need to identify alternative war fighting solutions suggests a look at Directed Energy Weapons (DEWs). The goal is to change the means by which warfare is conducted to improve operational efficiencies and overall effectiveness. The Naval Postgraduate School Systems Engineering and Analysis (SEA-19B) Capstone project team examined how existing directed energy technologies can provide performance across multiple warfare area domains and mission subsets for the U.S. Navy. The aim was to identify and characterize the capability gaps with conventional weapons systems, produce a coherent vision of naval missions that incorporate DEWs, and generate a roadmap for a DEW fleet. By conducting a thorough Analysis of Alternatives based on system performance, integration, schedule, and cost, the project team identified that the Tactical Laser System (with a laser beam power of 10 kW) provided the best overall capability to defend surface combatants, although none of the analyzed DEWs have the capability to replace a current conventional weapon. The Active Denial System (microwave) provided a niche capability in the Anti-Terrorism/Force Protection mission set.http://archive.org/details/viableshorttermd1094534734Approved for public release; distribution is unlimited