Unusual Presentation of Gall Bladder Perforation

Background: Gall bladder perforation (GBP) is a rare but life threatening complication of cholecystitis. Therefore, it continues to be an important problem for the surgeon. Aim: To report a case of perforated gall bladder mimicking perforated peptic ulcer disease. Methods: A case report of gall bladder perforation that was managed at the Nnamdi Azikiwe University Teaching Hospital. Result: A 67 years old woman who had a clinical diagnosis of perforated peptic ulcer disease secondary to chronic NSAID use but with intra-operative finding of Niemeier's type II gall bladder perforation. Conclusion: High index of suspicion is required to diagnose perforated gall bladder mimicking perforated peptic ulcer disease. Keywords: Gall bladder perforation, Peptic ulcer disease, Niemeier's Classificatio

Therapeutic management of Urinary Tract Infections (UTI): A retrospective study in two Teaching Hospitals in Nigeria

Urinary Tract Infection (UTI) is one of the most common diseases and a significant cause of morbidity in all age groups. There are large differences in the management of UTI with respect to definition, diagnosis and treatment. This retrospective study reviewed the diagnosis and drug treatment of UTI at the Teaching Hospitals of Ahmadu Bello University (ABUTH), Zaria and University of Maiduguri (UMTH). The results showed that majority of the infectionswere due to Escherichia coli, followed by Klebsiella species and Staphylococcus aureus. The symptoms were dysuria, suprapubic pain, fever and/or chills, and lower abdominal discomfort, which differed in order of occurrence at the two institutions. The infecting organisms were sensitive to pefloxacin, ceftriazone and gentamicin while the most frequently used antibiotics were gentamicin, ciprofloxacin and ampicillin/cloxacillin in decreasing order at ABUTH. At UMTH,ceftazidine, ofloxacin and gentamicin were frequently active against the infective organisms; and the most prescribed antibiotics were nitrofurantoin, ofloxacin, amoxicillin/clavulanic acid and co-trimoxazole in decreasing order. These results showed that institutional antibiotic policy in the treatment of urinary tract infections might have been based on the experience of the physician, cost of the drug and route of administration instead of prevalence and sensitivity patterns. It also showed that the guiding principle of the rational use of drugs is not strictly adhered to

Breast Lumps in NAUTH, Nnewi :A 5 year Review

Background Breast lump is the most common reason for presenting to breast clinics. It is a source of great anxiety to a female when it is discovered. Objective This study aims at a clinico-pathologic review of breast lump as a presenting complaint. Material and Methods A 5-year retrospective analysis of 550 patients presenting with a complaint of breast lump to the breast clinic of NnamdiAzikiwe University TeachingHospital (NAUTH) Nnewi, fromJanuary 2004 December 2008. Results Breast lump was the presenting complaint in 550(82.8%) of 664 patients presenting to the breast clinic. The lump was painless in 458 (83.3%), associated with pain and breast ulcer in 59(10.7%) and 33(6.0%) patients respectively. Females constitute 548(99.6%) with only 2(0.4%) males. There was no palpable lump in 23 patients (4.2%) on clinical examination and only 54 patients (9.7%) ad >1 lump. The clinical diagnosis were breast cancer in 260 patients (47.3%), fibroadenoma in 175 (31.8%), fibrocystic changes in 67 (12.2%) patients. The others were different types of benign diseases. Histopathology report was available in 294 patients with 161(54.8%), 56(19.0%) and 46(15.6%) patients diagnosed respectively as having invasive cancer, fibroadenoma, and fibrocystic changes. Conclusion Our study shows that breast lump was the most common presenting complaint with most patients not presenting early. Fewer lumps are discovered by breast self examination. The finding that breast cancer was slightly more common than benign breast lesions is at variance with most studies probably due to proliferation in our environment of private owned hospitals by general practitioners where most of the benign lesions are probably managed. But the finding of fibroadenoma as the most common of the benign lesions is similar to that reported by other researchers in Nigeria and other parts of theworld.KeyWords: breast lump, Nnewi,Revie

An incremental dual nu-support vector regression algorithm

© 2018, Springer International Publishing AG, part of Springer Nature. Support vector regression (SVR) has been a hot research topic for several years as it is an effective regression learning algorithm. Early studies on SVR mostly focus on solving large-scale problems. Nowadays, an increasing number of researchers are focusing on incremental SVR algorithms. However, these incremental SVR algorithms cannot handle uncertain data, which are very common in real life because the data in the training example must be precise. Therefore, to handle the incremental regression problem with uncertain data, an incremental dual nu-support vector regression algorithm (dual-v-SVR) is proposed. In the algorithm, a dual-v-SVR formulation is designed to handle the uncertain data at first, then we design two special adjustments to enable the dual-v-SVR model to learn incrementally: incremental adjustment and decremental adjustment. Finally, the experiment results demonstrate that the incremental dual-v-SVR algorithm is an efficient incremental algorithm which is not only capable of solving the incremental regression problem with uncertain data, it is also faster than batch or other incremental SVR algorithms

Transmutations and spectral parameter power series in eigenvalue problems

We give an overview of recent developments in Sturm-Liouville theory concerning operators of transmutation (transformation) and spectral parameter power series (SPPS). The possibility to write down the dispersion (characteristic) equations corresponding to a variety of spectral problems related to Sturm-Liouville equations in an analytic form is an attractive feature of the SPPS method. It is based on a computation of certain systems of recursive integrals. Considered as families of functions these systems are complete in the $L_{2}$-space and result to be the images of the nonnegative integer powers of the independent variable under the action of a corresponding transmutation operator. This recently revealed property of the Delsarte transmutations opens the way to apply the transmutation operator even when its integral kernel is unknown and gives the possibility to obtain further interesting properties concerning the Darboux transformed Schr\"{o}dinger operators. We introduce the systems of recursive integrals and the SPPS approach, explain some of its applications to spectral problems with numerical illustrations, give the definition and basic properties of transmutation operators, introduce a parametrized family of transmutation operators, study their mapping properties and construct the transmutation operators for Darboux transformed Schr\"{o}dinger operators.Comment: 30 pages, 4 figures. arXiv admin note: text overlap with arXiv:1111.444

Strain engineering and one-dimensional organization of metal-insulator domains in single-crystal VO2 beams

Spatial phase inhomogeneity at the nano- to microscale is widely observed in strongly-correlated electron materials. The underlying mechanism and possibility of artificially controlling the phase inhomogeneity are still open questions of critical importance for both the phase transition physics and device applications. Lattice strain has been shown to cause the coexistence of metallic and insulating phases in the Mott insulator VO2. By continuously tuning strain over a wide range in single-crystal VO2 micro- and nanobeams, here we demonstrate the nucleation and manipulation of one-dimensionally ordered metal-insulator domain arrays along the beams. Mott transition is achieved in these beams at room temperature by active control of strain. The ability to engineer phase inhomogeneity with strain lends insight into correlated electron materials in general, and opens opportunities for designing and controlling the phase inhomogeneity of correlated electron materials for micro- and nanoscale device applications.Comment: 14 pages, 4 figures, with supplementary informatio

Self-consistent field theory for the interactions between keratin intermediate filaments

Background: Keratins are important structural proteins found in skin, hair and nails. Keratin Intermediate Filaments are major components of corneocytes, nonviable horny cells of the Stratum Corneum, the outermost layer of skin. It is considered that interactions between unstructured domains of Keratin Intermediate Filaments are the key factor in maintaining the elasticity of the skin. Results: We have developed a model for the interactions between keratin intermediate filaments based on self-consistent field theory. The intermediate filaments are represented by charged surfaces, and the disordered terminal domains of the keratins are represented by charged heteropolymers grafted to these surfaces. We estimate the system is close to a charge compensation point where the heteropolymer grafting density is matched to the surface charge density. Using a protein model with amino acid resolution for the terminal domains, we find that the terminal chains can mediate a weak attraction between the keratin surfaces. The origin of the attraction is a combination of bridging and electrostatics. The attraction disappears when the system moves away from the charge compensation point, or when excess small ions and/or NMF-representing free amino acids are added. Conclusions: These results are in concordance with experimental observations, and support the idea that the interaction between keratin filaments, and ultimately in part the elastic properties of the keratin-containing tissue, is controlled by a combination of the physico-chemical properties of the disordered terminal domains and the composition of the medium in the inter-filament region. Keywords: Stratum corneum, Skin keratins, Intermediate filaments, Unstructured terminal domains, Bridging attractio

P2X receptor-mediated purinergic sensory pathways to the spinal cord dorsal horn

P2X receptors are expressed on different functional groups of primary afferent fibers. P2X receptor-mediated sensory inputs can be either innocuous or nociceptive, depending on which dorsal horn regions receive these inputs. We provide a brief review of P2X receptor-mediated purinergic sensory pathways to different regions in the dorsal horn. These P2X purinergic pathways are identified in normal animals, which provides insights into their physiological functions. Future studies on P2X purinergic pathways in animal models of pathological conditions may provide insights on how P2X receptors play a role in pathological pain states