Role of diversion ileostomy in low rectal cancer: A randomized controlled trial

AbstractIntroduction: Rectal cancer continues to be devastating malignancy worldwide. Sphincter preservation is the need of the hour. Distal anastomosis is more prone to leaks. Proximal diversion in form of ileostomy may be used to protect distal anastomosis. Aim: To compare two groups of low anterior resection with and without diversion ileostomy in rectal cancer patients. Material and methods: A prospective, hospital based study of 78 rectal carcinoma patients were taken for the study. Inclusion criteria was operable rectal cancer 4–12 cm from anal verge. Patients were randomized into two groups. Group – A (34 patient) patients with low anterior resection with ileostomy (LAR with ileostomy); Group – B (44 patients) patients with low anterior resection without ileostomy (LAR without ileostomy). Quality of life was assessed by scoring done by self designed method. A total score of 0–20 given for various parameters. Results: Skin excoriation was the commonest complication. Stomal retraction and stomal obstruction was seen in 1 patient each (3%). Hypokalemia was the commonest electrolyte imbalance present in ileostomy group. Anastomotic leak was present in 6% of Group A and 11% of Group B patients. Mean time of closure of ileostomy was 16 ± 4.3 weeks. Conclusion: LAR with ileostomy has certain advantages over LAR without ileostomy in terms of anastomotic leak, postoperative ileus, resumption of diet, wound infection, small bowel obstruction and in terms mortality and recurrence. However stoma related complications were main disadvantage in LAR with ileostomy

Spectrum of abdominal organ injury in a primary blast type

Research articl

Breast Gangrene

<p>Abstract</p> <p>Background</p> <p>Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene.</p> <p>Methods</p> <p>A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed</p> <p>Results</p> <p>All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area.</p> <p>Conclusion</p> <p>Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.</p

Characteristics of Copper-based Oxygen Carriers Supported on Calcium Aluminates for Chemical-Looping Combustion with Oxygen Uncoupling (CLOU)

Eight different oxygen carriers (OC) containing CuO (60 wt %) and different mass ratios of CaO to Al2O3 as the support were synthesized by wet-mixing followed by calcination at 1000 °C. The method of synthesis used involved the formation of calcium aluminum hydrate phases and ensured homogeneous mixing of the Ca2+ and Al3+ ions in the support at the molecular level. The performance of the OCs for up to 100 cycles of reduction and oxidation was evaluated in both a thermogravimetric analyzer (TGA) and a fluidized bed reactor, covering a temperature range of 800 to 950 °C. In these cycling experiments, complete conversion of the OC, from CuO to Cu and vice versa, was always achieved for all OCs. The reactivity of the materials was so high that no deactivation could be observed in the TGA, owing to mass transfer limitations. It was found that OCs prepared with a mass ratio of CaO to Al2O3 in the support >0.55 agglomerated in the fluidized bed, resulting in an apparent deactivation over 25 cycles for all temperatures investigated. High ratios of mass of CaO to Al2O3 in the support resulted in CuO interacting with CaO, forming mixed oxides that have low melting temperatures, and this explains the tendency of these materials to agglomerate. This behavior was not observed when the mass ratio of CaO to Al2O3 in the support was ≤0.55 and such materials showed excellent cyclic stability operating under redox conditions at temperatures as high as 950 °C.The authors thank Mohammad Ismail and Matthew Dunstan for helping with the XRD analysis and Alex Casabuena-Rodriguez and for helping with the SEM. This work was supported by the Engineering and Physical Sciences Research Council (EPSRC grant EP/I010912/1).This is the final version of the article. It first appeared from ACS via http://dx.doi.org/10.1021/acs.iecr.5b0117

Predicting Vulnerability for Requirements

Software security being one of the primary concerns in the software engineering community, researchers are coming up with many preemptive approaches aiming to minimize the vulnerabilities in the software. These approaches, dominated by static and dynamic analysis of the code often with machine learning (ML) techniques, are designed to detect vulnerabilities in the post-implementation stage of the software development life-cycle (SDLC). While they are found to be effective in detecting vulnerabilities, the consequences are often expensive. Accommodating changes after detecting a vulnerability in the system in later stages of the SDLC is very costly, sometimes even infeasible as it may involve changes in design or architecture. Moreover, the root of a vulnerability can often be traced back to the requirements specification. On that account, Imtiaz and Bhowmik have advocated a novel framework to provide an additional measure of predicting vulnerabilities at earlier stages of the SDLC. In this study, we build upon their proposed framework and leverage state-of-the-art ML algorithms to predict vulnerabilities for new requirements. We also present a case study on a large open-source-software (OSS) system, Firefox, evaluating the effectiveness of the extended prediction module. The results demonstrate that the framework could be a viable complement to the traditional yulnerability-fighting approaches