Diagnostic Performance of Ultrasonography for Identification of Small Bowel Obstruction: A Systematic Review and Meta-analysis

Introduction: Small bowel obstruction (SBO) is known as a common cause of acute abdominal complaints in the emergency department (ED). The modality of choice for the diagnosis of SBO has not yet been established. This systematic review and meta-analysis aimed to investigate the accuracy of ultrasonography for the diagnosis of SBO. Methods: Systematic search was performed on five electronic databases including Medline, Scopus, Web of Sciences, Embase, and Cochrane Library, and the retrieval period was from the inception of each database to November 2023. The quality of the included studies were investigated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled values of diagnostic characteristics for ultrasonography were estimated using meta-Disc and Stata statistical software. Results: Twenty-one studies with a total of 1977 patients were included in the meta-analysis. The pooled estimate for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary ROC curve of ultrasonography for diagnosing SBO were 0.93 (95% CI: 0.91–0.95), 0.8 (95% CI: 0.77–0.83), 5.69 (95% CI: 3.64–8.89), 0.1 (95% CI: 0.07–0.16), 83.51 (95% CI: 18.12–182.91) and 0.96, respectively. Conclusion: The findings of this meta-analysis showed that the utilization of ultrasonography holds promise as a diagnostic imaging for SBO with high accuracy. However, additional worldwide studies are essential to get more evidence on the value of ultrasonography for the diagnosis of SBO

Population status, biology and ecology of the Maral, Cervus elaphus maral, in Golestan National Park, Iran

Abstract. The habitat and population characteristics of the Maral, Cervus elaphus maral Gray, 1850, were studied in Golestan National Park, Iran, from 1975 to 2003 (but more intensively from 1976 in the three vegetation types present; Caspian deciduous forest, transition zone, and steppe. Forest meadows and the transition zone were the preferred habitats. Hahn's census method and pellet group counts gave a population number of 1897 -2096 Marals during 1976 Since then the population size has declined, to 500 in 2003. The average Maral group size was 4.6. The sex ratio among adults was 27 stags per 100 hinds. The number of calves produced per 100 hinds was 28. The annual mortality rate was 13.9% and life expectancy was 6.7 years. The decline of the Maral population in Golestan National Park was correlated with a similar trend in the Maral population in the Caspian forest (Hyrcanian region). Illegal hunting, road kill and livestock grazing have been identified as the major factors which affect the Maral population adversely. Tiere. Die durchschnittliche Gruppengröße betrug 4.6; das Geschlechterverhältnis betrug bei Alttieren 27 männlichen Hirschen zu 100 Hirschkühen. Die Anzahl der Kälber pro 100 Hirschkühe betrug 28, die jährliche Mortalität 13,9% und die durchschnittliche Lebenserwartung 6,7 Jahre. Die Entwicklung der Population im Golestan-Nationalpark korreliert mit einem fast gleichen Trend, der bei der Rotwildpopulation in den Kaspischen Wäldern (Hercynische Region) zu beobachten ist. Illegale Jagd, Verkehrsopfer und Beweidung durch Haustiere wurden als die wichtigsten Faktoren erkannt, die die Rotwildpopulation negativ beeinflussen

Exploring the application of the hybrid nano-bioreactor technology based on the developed polyethersulfone mixed-matrix membrane for industrial effluent treatment

Due to the high concentration of various contaminants in the paper mill effluent, it must undergo an efficient treatment process before being discharged to the environment or being reused in the production cycle. In the present study, the submerged membrane adsorption bioreactor (SMABR) system was used for the treatment of the paper mill effluent. The modified polyethersulfone PES/MoS2 membrane was fabricated by incorporating exfoliated MoS2 nanosheets prepared in the laboratory, into the PES matrix. This membrane along with the powdered activated carbon (PAC) were utilized in the SMABR system for the paper mill effluent treatment. After the acclimation of the sludge with the target effluent, the optimum values of food to microorganism (F/M), hydraulic retention time (HRT), and adsorbent dosage were determined separately to be 0.451, 18 h, and 3 g/L by considering the maximum values of chemical oxygen demand (COD) removal and mixed liquor suspended solid MLSS concentration in each stage. In the final stage, the MBR and SMABR systems (using the pristine and modified membranes, separately) were prepared to separately investigate the effect of the presence of the PAC adsorbent and modified membrane, on the output parameters. In all systems, the values of pH and dissolved oxygen (DO) were maintained in the normal range (pH: 6.2–6.7, DO>2) to provide favorable conditions for the growth of microorganisms. Most importantly, best performance in this study was related to the SMABR system consisting the PES/MoS2 membrane and PAC adsorbent, with the highest values of COD removal (96%), MLSS concentration (15620 mg/L), and membrane permeation flux (110 L/m2.h). It is worth mentioning that the functionalized membrane exhibited better hydrophilicity compared with the pristine membrane, resulting in high water permeation flux, which is in accordance with the performance results

Muscular and hepatosplenic candidiasis in a patient with acute myeloblastic leukemia: A case report and literature review

Key Clinical Message Muscular and subcutaneous candidiasis is a rare entity in immunocompromised patients, but it should be kept in mind when we see multiple cystic soft tissue masses in addition to target‐shaped hepatosplenic lesions in neutropenic patients. US and MRI are useful imaging modalities for the diagnosis and follow‐up of these patients. Abstract Soft tissue candidiasis is an opportunistic infection in immunocompromised patients and must always be diagnosed and treated as soon as possible. In this case report, the patient is a 14‐year‐old boy with acute myeloid leukemia M3‐type who presented with numerous soft tissue and hepatosplenic candidal abscesses

Gliomatosis cerebri with blindness: A case report with literature review

Cerebral gliomatosis (GC) is a rare diffuse infiltrative growth pattern of glioma with nonspecific clinical manifestations like visual impairment that may involve bilateral temporal lobes. Herpes simplex encephalitis (HSE) and limbic encephalitis (LE) can also lead to temporal lobe involvement. Differentiating these entities is necessary for patients with misleading presentations and imaging findings. To the best of our knowledge, this is the third case of GC presenting with blindness. The patient was a 35 years-old male in a drug rehabilitation center for heroin addiction. He presented with a headache, a single episode of seizure, and a 2-month history of bilateral decrease in visual acuity, which had acutely worsened. Magnetic resonance imaging (MRI) and computed tomography (CT) showed bilateral temporal lobe involvement. Ophthalmological studies showed bilateral papilledema, absence of visual evoked potential, and thickening of the retinal nerve fiber layer. Due to this clinical presentation, normal laboratory data, and suspicious MRI findings, further investigation with magnetic resonance spectroscopy (MRS) was performed. Results showed a greatly increased ratio of choline to creatinine(Cr) or N-acetyl aspartate (NAA), suggesting a neoplastic nature of the disease. Subsequently, the patient was referred for a brain tissue biopsy with a suspicion of malignancy. The pathology results revealed adult-type diffuse glioma with isocitrate dehydrogenase (IDH) mutation. Bilateral blindness, as well as bilateral temporal lobe involvement, each has many different causes. However, as demonstrated in this study, adult-type diffuse glioma must be considered a rare cause of concomitant bilateral temporal lobe involvement and blindness