Surgeon-performed sonographic findings in a traumatic trans-anal rectal perforation

Early diagnosis and active management of trans-anal rectal injuries is essential for a favorable outcome. Intraperitoneal free air (IFA) is usually diagnosed by an erect Chest X-ray. Point-of-care ultrasound has been recently used to detect IFA. We report a 45-year-old male who presented to the Emergency Department with lower abdominal peritonitis. Surgeon-performed portable point-of-care ultrasound as an extension of the abdominal examination revealed an inflamed omentum with hypoechoic stranding, thickened non compressible small bowel, and free fluid in the pelvis. A transverse abdominal section of the right upper quadrant showed free intraperitoneal air. Rectal examination revealed a longitudinal rectal tear. Laparotomy has confirmed the sonographic findings. There was a 12 cm intraperitoneal tear of the anterior wall of the rectum which was necrotic. This case clearly demonstrates that portable point-of-care ultrasound gives very useful detailed information even when performed by a non radiologist. Surgeons should be encouraged to use point-of-care ultrasound after appropriate training

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Background: Human pancreatico-duodenal injuries caused by camels are extremely rare.Objective: We report three patients who sustained camel-related pancreatico-duodenal injuries and review the literature on this topic.Results: A 32-year camel caregiver was kicked by a camel which then stepped on his abdomen trying to kill him. The patient’s abdomen was soft and lax. CT scan of the abdomen showed free retroperitoneal air. Laparotomy revealed a complete tear of the anterior wall of the second part of duodenum which was primarily repaired. A 40-year camel caregiver was directly kicked into his abdomen by a camel. He developed traumatic pancreatitis which was treated conservatively. A 31-year-old male fell down on his abdomen while riding a camel. Abdominal examination revealed tenderness and guarding. Abdominal CT Scan showed complete transection of the neck of the pancreas which was confirmed by laparotomy. The patient had distal pancreatectomy with preservation of the spleen. All patients were discharged home in good condition.Conclusion: These cases demonstrate the misleading presentation of the camel-realted pancreatico-duodenal injuries and their unique mechanism of injury.Key words: Duodenum, pancreas, pancreatitis, injury, trauma, came

An Arabic CCG approach for determining constituent types from Arabic Treebank

AbstractConverting a treebank into a CCGbank opens the respective language to the sophisticated tools developed for Combinatory Categorial Grammar (CCG) and enriches cross-linguistic development. The conversion is primarily a three-step process: determining constituents’ types, binarization, and category conversion. Usually, this process involves a preprocessing step to the Treebank of choice for correcting brackets and normalizing tags for any changes that were introduced during the manual annotation, as well as extracting morpho-syntactic information that is necessary for determining constituents’ types. In this article, we describe the required preprocessing step on the Arabic Treebank, as well as how to determine Arabic constituents’ types. We conducted an experiment on parts 1 and 2 of the Penn Arabic Treebank (PATB) aimed at converting the PATB into an Arabic CCGbank. The performance of our algorithm when applied to ATB1v2.0 & ATB2v2.0 was 99% identification of head nodes and 100% coverage over the Treebank data

Seatbelt syndrome associated with an isolated rectal injury: case report

Seatbelt syndrome is defined as a seatbelt sign associated with a lumbar spine fracture and a bowel perforation. An isolated rectal perforation due to seatbelt syndrome is extremely rare. There is only one case reported in the Danish literature and non in the English literature. A 48-year old front seat restrained passenger was involved in a head-on collision. He had lower abdominal pain and back pain. Seatbelt mark was seen across the lower abdomen. Initial trauma CT scan was normal except for a burst fracture of L5 vertebra which was operated on by internal fixation on the same day. The patient continued to have abdominal pain. A repeated abdominal CT scan on the third day has shown free intraperitoneal air. Laparotomy has revealed a perforation of the proximal part of the rectum below the recto sigmoid junction. Hartmann's procedure was performed. The abdomen was left open. Gradual closure of the abdominal fascia over a period of two weeks was performed. Postoperatively, the patient had temporary urinary retention due to quada equina injury which resolved 10 months after surgery. The presence of a seatbelt sign and a lumbar fracture should raise the possibility of a bowel injury

Paraoxonase Activity and Expression Is Modulated by Therapeutics in Experimental Rat Nonalcoholic Fatty Liver Disease

Objective. The objective of the present study is to investigate the effect of rosiglitazone, metformin, ezetimibe, and valsartan (alone or in combinations) on paraoxonase (PON) activity and PON-mRNA expression in nonalcoholic fatty liver disease (NAFLD). Methods. 54 Male Sprague–Dawley rats were divided to 9 groups: chow diet group (15 weeks); methionine-choline-deficient diet (MCDD) group (15 weeks); MCDD-treated groups for the last 6 weeks with either metformin (M), rosiglitazone (R), metformin plus rosiglitazone (M+R), ezetimibe (E), valsartan (V), or a combination of R+M+V or of R+M+V+E for a total period of 15 weeks. Results. PON activities in serum and liver were decreased in MCDD rats. PON activity in serum increased significantly in all treatment groups. PON activity in liver was also increased significantly, except only in groups R, E, V, R+M+V, and R+M+V+E. Liver PON3 mRNA expression increased significantly in groups R+M, E, V, R+M+V, and R+M+V+E whereas liver PON2 mRNA expression increased significantly in MCDD, R+M, E, V, R+M+V, and R+M+V+E. Conclusions. PON activities in serum and liver were decreased in NAFLD. Treatment with insulin sensitizers, ezetimibe, and valsartan increased PON activity and reduced oxidative stress both in serum and liver

GNSS Vulnerabilities and Existing Solutions:A Review of the Literature

This literature review paper focuses on existing vulnerabilities associated with global navigation satellite systems (GNSSs). With respect to the civilian/non encrypted GNSSs, they are employed for proving positioning, navigation and timing (PNT) solutions across a wide range of industries. Some of these include electric power grids, stock exchange systems, cellular communications, agriculture, unmanned aerial systems and intelligent transportation systems. In this survey paper, physical degradations, existing threats and solutions adopted in academia and industry are presented. In regards to GNSS threats, jamming and spoofing attacks as well as detection techniques adopted in the literature are surveyed and summarized. Also discussed are multipath propagation in GNSS and non line-of-sight (NLoS) detection techniques. The review also identifies and discusses open research areas and techniques which can be investigated for the purpose of enhancing the robustness of GNSS

Sex Hormones Changes in Blood and Their Effect on Fecundity of African Catfish (Clarias gariepinus Burchell, 1822) after Being Injected with Different Doses of Human Chorionic Gonadotropin (HCG) Hormone

This study was conducted to investigate the effect of different dosesinjection of human chorionic gonadotropin (HCG) hormone on fecundityand serum sex hormones (FSH, LH, estrogen (E2), progesterone (P4),testosterone (T)) of African catfish (Clarias gariepinus). African catfishspawners were intermuscularly injected with different doses of HCG(500, 1500, 3000, 6000 IU/kg female), and group is not injected as acontrol; males were injected at half the female dose. The results showedthat, fish group injected by 6000 IU HCG/ kg female had the highestgonadsomatic index, absolute fecundity and relative fecundity, while,the lowest value of absolute fecundity and relative fecundity wererecorded with 500 IU HCG/ kg female. The group injected with thehighest amount of HCG (6000 IU/ kg female) recorded the lowest valuefrom egg diameter, while the highest egg diameter was observed in 500IU HCG/ kg female. In females, the group injected with 6000 IU HCG/kg female reflected the lowest level of FSH and the highest level of LHand the highest level of P4 compared to other treatments. Level of Trecorded the highest level with 1500 IU HCG/ kg female. The controlgroup reflected the highest level of FSH and E2, while the control groupreflected the lowest level of T and P4 level. In males, serum FSH, LH,P4 and E2 in male groups injected with HCG were relatively higher thanthose recorded in the control group. The highest level of T was recordedin treatment injected with the highest dose of HCG and decreased inother treatments until recorded the lowest level of T in the controlgroup. It was observed, HCG hormone has successfully and accelerateinduced spawning in African catfish (Clarias gariepinus) and increasedin reproductive performance with the increase in HCG dosage and ascompared to group not injected

Towards a national trauma registry for the United Arab Emirates

<p>Abstract</p> <p>Background</p> <p>Trauma is a major health problem in the United Arab Emirates (UAE) as well as worldwide. Trauma registries provide large longitudinal databases for analysis and policy improvement. We aim in this paper to report on the development and evolution of a national trauma registry using a staged approach by developing a single-center registry, a two-center registry, and then a multi-center registry. The three registries were established by developing suitable data collection forms, databases, and interfaces to these databases. The first two registries collected data for a finite period of time and the third is underway. The steps taken to establish these registries depend on whether the registry is intended as a single-center or multi-center registry.</p> <p>Findings</p> <p>Several issues arose and were resolved during the development of these registries such as the relational design of the database, whether to use a standalone database management system or a web-based system, and the usability and security of the system. The inclusion of preventive medicine data elements is important in a trauma registry and the focus on road traffic collision data elements is essential in a country such as the UAE. The first two registries provided valuable data which has been analyzed and published.</p> <p>Conclusions</p> <p>The main factors leading to the successful establishment of a multi-center trauma registry are the development of a concise data entry form, development of a user-friendly secure web-based database system, the availability of a computer and Internet connection in each data collection center, funded data entry personnel well trained in extracting medical data from the medical record and entering it into the computer, and experienced personnel in trauma injuries and data analysis to continuously maintain and analyze the registry.</p

Paraoxonase Activity and Expression Is Modulated by Therapeutics in Experimental Rat Nonalcoholic Fatty Liver Disease

Objective. The objective of the present study is to investigate the effect of rosiglitazone, metformin, ezetimibe, and valsartan (alone or in combinations) on paraoxonase (PON) activity and PON-mRNA expression in nonalcoholic fatty liver disease (NAFLD). Methods. 54 Male Sprague-Dawley rats were divided to 9 groups: chow diet group (15 weeks); methionine-choline-deficient diet (MCDD) group (15 weeks); MCDD-treated groups for the last 6 weeks with either metformin (M), rosiglitazone (R), metformin plus rosiglitazone (M+R), ezetimibe (E), valsartan (V), or a combination of R+M+V or of R+M+V+E for a total period of 15 weeks. Results. PON activities in serum and liver were decreased in MCDD rats. PON activity in serum increased significantly in all treatment groups. PON activity in liver was also increased significantly, except only in groups R, E, V, R+M+V, and R+M+V+E. Liver PON3 mRNA expression increased significantly in groups R+M, E, V, R+M+V, and R+M+V+E whereas liver PON2 mRNA expression increased significantly in MCDD, R+M, E, V, R+M+V, and R+M+V+E. Conclusions. PON activities in serum and liver were decreased in NAFLD. Treatment with insulin sensitizers, ezetimibe, and valsartan increased PON activity and reduced oxidative stress both in serum and liver

Spontaneous Bacterial Peritonitis in the Medical Intensive Care Unit of a University Hospital in Egypt: Frequency, Bacteriological Profile, Risk Factors and Outcomes

Objectives: This work was carried out to assess the frequency of spontaneous bacterial peritonitis (SBP) and its variants in the medical intensive care unit (ICU) of the Internal Medicine department, zagazig Faculty of Medicine, Egypt and to identify the causative organisms and their susceptibility to commonly used antimicrobials. Other objectives were to determine risk factors and clinical outcomes. Subjects and methods: One-hundred and eighty- nine patients having ascites due to liver cirrhosis were studied. Each patient was subjected to: history collection, physical examination, diagnostic paracentesis, radiological and laboratory investigations and assessment of disease severity. Organisms isolated were identified and their antibiotic susceptibility profiles were tested. MELD score was used for diseases assessment. Risk factors and clinical outcomes were concluded using statistical methods. Results: Frequency of SBP was 56.1%. Classic SBP accounted for 47.2% of cases, while the remaining 52.8% were culture negative neutrocytic ascites (CNNA). E-coli were the most frequently isolated bacteria. Piperacillin- tazobactam was the most effective antibiotic.&nbsp; SBP cases were significantly associated with hepatocellular carcinoma and with use of beta blockers. Patients with SBP were more likely to present with fever and abdominal pain, whereas those with non- SBP were more likely to present with hypotension. Non- significant relationship was found between SBP and non-SBP cases regarding ICU stay. Meanwhile mortality was higher among SBP cases; age and MELD score were the independent risk factor