Neoaorta reconstruction using both femoral veins in a patient with secondary aortoenteric fistula

In situ reconstruction using femoral veins is emerging as one of the acceptable options for aortic reconstruction in patients with aortoduodenal fistula. We report a 35-year young male who presented with secondary aortoenteric fistula. His infected aortic graft was removed and was successfully managed by neo-aortic reconstruction, using both femoral veins in a \u27pantaloon\u27 fashion. He had smooth postoperative recovery and did not have graft re-infection. He did not show signs of chronic venous insufficiency on long-term follow-up

Cocoon abdomen - a rare cause of intestinal obstruction.

Abstract INTRODUCTION: Sclerosing encapsulating peritonitis or abdominal cocoon is a rare condition of unknown etiology in which intestinal obstruction result from encasement of variable length of bowel by dense fibro collagenous membrane. PRESENTATION OF CASE: A case of young male is reported who presented with features of small bowel obstruction with tender mass in the right iliac fossa. CT scan suggested features of internal herniation. On exploration, he was found to have small intestine, large intestine, stomach and liver covered with a thick cocoon like membrane. The membrane was gently peeled off the small intestine. The patient recovered well and was discharged on an oral diet. DISCUSSION: Preoperative diagnosis of abdominal cocoon is difficult and most cases are discovered incidentally on laparotomy. Contrast enhanced computed tomography or barium meal may be helpful in preoperative diagnosis. Surgical treatment is the main stay of treatment for this condition. Simple removal of the membrane and lysis of the adhesions produces optimal outcome. Bowel resection is indicated only when the intestine is nonviable. CONCLUSION: A high index of suspicion and appropriate radiology can prevent \u27surprises\u27 and unnecessary bowel resection. Simple removal of the membrane gives a good outcome

A framework for QoS driven user-side cloud service management

This thesis presents a comprehensive framework that assists the cloud service user in making cloud service management decisions, such as service selection and migration. The proposed framework utilizes the QoS history of the available services for QoS forecasting and multi-criteria decision making. It then integrates all the inherent necessary processes, such as QoS monitoring, forecasting, service comparison and ranking to recommend the best and optimal decision to the user

Abdominal vascular injuries- What general/ trauma surgeons should know?

Abdominal vascular injuries are the common cause of death post-trauma. These are challenging injuries to manage due to severe haemodynamic instability, other associated injuries and difficulty in accessing and controlling these deep-seated vessels. Early control of bleeding can decrease mortality in these patients. Abdominal vasculature is divided into three zones, each requiring different operative strategy for exposure. Standard vascular surgery principles of achieving proximal and distal control before exploring any haematoma are followed when managing these injuries. Resuscitative endovascular balloon occlusion of aorta is a minimally invasive method of achieving proximal aortic occlusion. This also acts as bridge for definitive intervention or surgery. Endovascular interventions, including angioembolisation and stent-graft, have shown to improve outcomes, especially in patients with blunt abdominal trauma. Updated knowledge is necessary for all those directly involved in managing these patients. The current narrative review was planned to discusses relevant anatomy, principles, different surgical approaches and endovascular techniques to deal with these injuries

SOCIO-JUSTICE: ACTING LIKE A CATALYST IN NURTURING THE INTERFAITH RELATIONSHIPS

This article aims to elucidate that the role of religion is influential in casting notions of social impartiality, despotism, subjugation, and emancipation. It will be explained in this article that according to Islamic teachings, injustice is explained as one of the abysmal forms of evil, that justice and neutrality should not be predicated on a specific group of people, religious belief, race, caste, creed, or faith it should be done with each creation of God. Examples of social justice will also be given from prominent non-revelational religions. Finally, it will be explained that Islam stands as an ambassador religion to safeguard the rights of the entire community and a staunch icon of religion in this interfaith religion’s dialogue. To conclude, it will be justified that the concept of social justice prevails in each religion, whether it is implemented practically or not is another topic of debate, but Social Justice is the need of the hour