Acute small bowel obstruction secondary to intestinal endometriosis, an elusive condition: a case report

<p>Abstract</p> <p>Background</p> <p>Endometriosis is a benign condition affecting females of reproductive age. Although intestinal endometriosis is common it is rare for the condition to manifest as an acute bowel obstruction secondary to ileocaecal and appendicular endometriosis. This case is important to report as it highlights the diagnostic difficulty this particular condition presents to an emergency surgeon.</p> <p>Case presentation</p> <p>We present the case of a 33 year old female of Asian origin who presented with symptoms and signs of an acute small bowel obstruction. A right hemicolectomy for suspected malignancy was performed with an ileocolic anastomosis. Histological examination demonstrated extensive endometriosis of the appendix and ileocaecal junction.</p> <p>Conclusion</p> <p>Enteric endometriosis should be considered as a differential diagnosis when assessing females of reproductive age with acute small bowel obstruction. A high index of suspicion is required to arrive at a diagnosis of this elusive condition.</p

MATHEMATICAL ANALYSIS OF 2-D STEADY SEEPAGE FLOW AND THE BEHAVIOR OF CONTAMINATES TRANSPORTATION THROUGH HOMOGENEOUS EARTH DAM USING COMSOL SOFTWARE

Seepage is a flow that happens through / under hydraulic structures or through the porous media such as in the case of earth dams from upstream to downstream due to difference in the hydraulic head. Study of seepage flow is important for hydraulic engineering. Before the structures being built, the behaviors of the seepage flows must be predicted because the seepage flow causes harmful to hydraulic structures. In this paper, a homogenous earth dam with sand material is proposed and constructed with horizontal bed filter at the Toe of the dam is taken as a case study. Through this Comsol is used to interpret the seepage of flow and contaminants transportation through the dam. The general objective of this paper is thus to present a prediction model aimed at quantifying a selected concentration of contaminants in the reservoir, and then predicted in the body of the dam, and at the exit from the dam. Computation Fluid Dynamics (CFD) Module (Comsol version 4.2) with its sub-programs named (Free and Porous Media Flow and Species Transport through Porous Media) was used in the analysis and study the seepage flow and of the contaminants transportation. This software is based on the finite element techniques that were used for solving the governing equations of flow and transportation of contaminant through porous media. Also, it was used to determine the phreatic line, amount of seepage within the dam, the pressure head, the total head, and the amount of contaminates transported through the dam body. From the comsol software, it is deduced that when the water level is at the maximum height (20m), it needs 12 days and (18) hr, at normal height (15m) it needs 29 days, while at a minimum height (8 m) it needs 81 days to reach the drain zone

Pathogenesis and A Practical Guide to the Management of Steven-Johnson Syndrome & Toxic Epidermal Necrolysis

Steven Johnson Syndrome (SJS) and Toxic Epidermal necrolysis are rare dermatological emergencies that are associated with a high degree of morbidity and mortality [1]. They are considered to be severe blistering conditions that portray an image of diffuse epidermal necrolysis in association with sloughing of the skin. SJS and TEN are effectively the same disease with the main difference being the percentage of body surface area involved. It is widely accepted that SJS belongs to the below 10% body surface area category and TEN to the more than 30% category. A Steven Johnson syndrome and Toxic Epidermal Necrolysis overlap exists when the body surface area affected is between 10 percent and 30 percent [2]. The causes of both conditions within this spectrum are most likely drug related, however certain infections can also trigger SJS/TEN but this is less likely. In a substantial number of cases the cause is idiopathic [3]. The main grading system is the SCORTEN criteria, which can also provide more information regarding prognosis and mortality [4]. Management of this condition is highly controversial with no clear guidelines but there is a wide agreement that patients should be managed in a burns unit with intravenous fluids and protection from secondary infections. Stopping all medications and investigating for the cause is important unless there is clear benefit from any single medication

Human Papilloma Virus and Squamous Cell Carcinoma of the Anus

The incidence of anal cancer is increasing. In the UK, the incidence is estimated at approximately 1.5 per 100,000. Most of this increase is attributed to certain at-risk populations. Persons who are human immunodeficiency virus (HIV)–positive and men who have sex with men (MSM), Organ transplant recipients, women with a history of cervical cancer, human papilloma virus (HPV), or cervical intraepithelial neoplasia (CIN) are known to have a greater risk for anal cancer. This paper will focus on HPV as a risk factor for anal intraepithelial neoplasia (AIN) and discusses the etiology, anatomy, pathogenesis, management of squamous cell carcinoma (SCC) of the anus