Multislice computed tomography evaluation of primary abdominal fat necrosis : a rare cause of acute abdominal pain

Purpose: Abdominal fat necrosis is a rare cause of abdominal acute pain, classified into primary or secondary according to the cause. Primary fat necrosis includes epiploic appendagitis or idiopathic infarction of the greater omentum. This retrospective study focuses on multislice computed tomography (MSCT) findings and diagnosis of primary abdominal fat necrosis as a cause of acute abdomen. Material and methods: This was a retrospective study with 20 patients included, presented to emergency room with acute abdominal pain diagnosed as primary fat necrosis. Retrospective evaluation was made of the patients' clinical data, presentation, CT studies done at the acute stage, and their primary and final diagnosis. Results: Twenty patients (eight male and 12 female, mean age 45 years, age range 20-70 years) diagnosed with abdominal fat necrosis (primary omental infarct) on CT imaging between October 2014 and June 2018 were evaluated. Clinically, five patients were suspected to be cholecystitis¸ eight patients as appendicitis, and four patients as diverticulitis. In addition, three patients had renal colic and were suspected to have ureteric stones; they showed suspected areas of abnormal fat density in non-contrast CT of the urinary tract. Idiopathic omental infarctions were detected in 13 patients on CT; all were on the right side. Laparoscopic excision was done for all. The other seven patients had epiploic appendagitis, seen on the left side, treated with conservative management. Conclusions: Primary fat necrosis, although rare, can be presented as acute abdomen. MSCT is the main diagnostic tool for diagnosis of omental infraction and differentiation between other causes of acute abdomen

Role of consumer satisfaction in mediating effect of product quality on repurchase intention

The purpose of this study is to explain the effect of product quality on consumer satisfaction and repurchase intention Berrybenka.com consumers in the city of Denpasar. The sample used was Berrybenka.com consumers in the city of Denpasar with a total of 105 respondents with a sample collection technique using purposive sampling. This research uses PLS (Partial Least Square) analysis technique. The results found that the quality of the product had a significant positive effect on repurchase intentions. Product quality has a significant positive effect on customer satisfaction. Consumer satisfaction has a significant positive effect on repurchase intentions. Consumer satisfaction acts as a partial mediating variable on the effect of the relationship of product quality on repurchase intentions. The implications of this study indicate that to increase the repurchase intention of its products, Berrybenka.com should need to pay attention to the factors of product quality and customer satisfaction. To maintain and increase market share, Berrybenka.com needs to maintain the quality of its products. Good product quality will increase customer satisfaction and encourage repurchase intentions of Berrybenka.com consumers in the future

Pre-emptive nebulization of lidocaine epinephrine before anesthesia for rigid bronchoscopy in pediatric: a randomized controlled study

Background: Foreign body aspiration in pediatrics is usually managed by rigid bronchoscopy, which is associated with plenty of adverse events. Objective: We tried to compare the effect of nebulized saline, lidocaine or combined lidocaine with epinephrine on postoperative respiratory complications.Patients and methods: This prospective study included 90 children, who were divided into three groups according to the nebulized solution; NS group (normal saline 0.9%), L group (lidocaine 1% 4 mg.kg- 1) and LA group [4 mg.kg- 1 lidocaine 1% and adrenaline (1:1000) 3 mg). Our primary outcome was the incidence of post-operative respiratory complications, while the secondary ones included hemodynamic changes and the incidence of intraoperative cough or desaturation. Results: All pre-procedural data were insignificant among the three groups. The LA group expressed higher heart rates, while the L group showed a significant reduction when compared to NS group. Propofol consumption showed a significant decline in two studied groups compared to the NS group. Intraoperative cough was higher in NS group in comparison to L and LA groups. Although, intraoperative desaturation per case along with post-operative sedation showed no significant difference among the three groups, post-operative cough frequency attacks and severity were higher in NS group when compared to L and LA group and when L group were compared to LA group. Post-operative stridor was insignificant among the three groups.Conclusion: Nebulized lidocaine/adrenaline combination is appropriate option to achieve proper intraoperative sedation and upper airway conditions with reduction of post-operative negative respiratory outcomes together with minor hemodynamic changes

Diffusion tensor magnetic resonance imaging : is it valuable in the detection of brain microstructural changes in patients having migraine without aura?

Purpose: The aim of this study is to assess the diagnostic value of diffusion tensor magnetic resonance imaging (MRI) in the detection of brain microstructural changes in patients having migraine without aura. Material and methods: Our prospective study included 33 patients having migraine without aura and 15 volunteers with matched age and sex, who underwent brain MRI with diffusion tensor imaging (DTI). The fractional anisotropy (FA) and mean diffusivity (MD) of selected grey and white matter regions on both sides were measured and correlated with the neurological clinical examination. Results: Significant differences were detected in MD values in the thalamus, globus pallidus, and hippocampus head on the right side of patients versus controls. Also, significant differences of the FA values were detected in the thalamus, globus pallidus, and hippocampus head on the right side of patients versus controls. Regarding the FA values of the same regions on the left side, a significant difference in the FA value was detected only in the hippocampus head. There was a statistically significant difference in the FA values on both sides of the white matter of the frontal lobes, posterior limbs of the internal capsules, and cerebellar hemispheres in patients compared to controls. There was a statistically significant difference in MD values in the white matter of both frontal lobes, posterior limb of the right internal capsule, and both cerebellar hemispheres in patients compared to controls. Conclusions: DTI can detect microstructural changes of the grey and white matter in patients having migraine without aura that could not be detected by conventional MRI

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Recycling of used engine oil by different solvent

The refining of lubricating oils from waste lubricating oil was examined utilizing a novel blend of solvent extraction and activated alumina adsorbent. The activity of these solvent extraction blends {toluene, butanol and methanol (A)}, {toluene, butanol and ethanol (B)} and {toluene, butanol and isopropanol (C)} was evaluated experimentally, oil to solvent proportions from 1:1 to 1:3 were analyzed for mixture blend (C). The results confirm solvent mixture (A) gave good efficiency with the highest percent sludge removal. The maximum percent of sludge removal improves with the increase of solvent to oil ratios. The physical properties of the recycle oil were measured. The results show the change in the properties of recycling oil and have good efficiency. Keywords: Re-recycling used lube oil, Solvent extraction, Adsorptio

Hubungan Kecerdasan Emosional Terhadap Tingkat Stres Mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warmadewa Di Masa Pandemi COVID-19

The COVID-19 pandemic has had a major impact on various sectors of life, including the world of education in Indonesia Online learning is one of the developments that occur in the field of education. This condition can affect the stress level of students. Previous studies have reported that there is a link between emotional intelligence and stress. The purpose of this study was to determine the relationship between emotional intelligence and stress levels of students from the Faculty of Medicine and Health Sciences, Warmadewa University during the COVID-19 pandemic. This research is an analytic study with a cross sectional design. The sample of this study were 106 students of the Faculty of Medicine and Health Sciences, Warmadewa University. This survey revealed, out of 106 respondents, 67.9% had high emotional intelligence and 32.1% students with low emotional level. Analysis of stress levels obtained 59.4% of students classified as normal and 40.6% classified as stressed. Statistical analysis shows that there is a relationship between emotional intelligence and stress levels with a p value <0.05 and an OR of 2.675. These results indicate that respondents who have low emotional intelligence are 2 times more likely to experience stress than respondents who have high emotional intelligence.Pandemi COVID-19 berdampak besar dalam berbagai sector kehidupan termasuk dunia pendidikan di Indonesia. Pembelajaran online merupakan salah satu perkembangan yang terjadi di bidang pendidikan. Kondisi ini dapat mempengaruhi tingkat stres mahasiswa. Studi terdahulumelaporkan bahwa terdapat keterkaitan antara kecerdasan emosional dan stres. Tujuan dari penelitian ini untuk mengetahui hubungan antara kecerdasan emosional dengan tingkat stres mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warmadewa di masa pandemi COVID-19. Penelitian ini merupakan studi analitik dengan desain cross sectional. Sampel penelitian ini ialah mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warmadewa sebanyak 106 mahasiswaSurvei ini mengungkapkan, dari 106 responden, 67,9% mempunyai kecerdasan emosional tinggi dan 32,1% mahasiswa dengan tingkat emosional rendah. Analisis tingkat stres diperoleh 59.4% mahasiswa tergolong normal dan 40,6% tergolong stress. Analisis statistik menunjukan bahwa terdapat hubungan antara kecerdasan emosional dengan tingkat stres dengan nilai p<0,05 dan OR sebesar 2,675. Hasil ini menunjukkan bahwa responden yang memiliki kecerdasan emosional rendah berisiko 2 kali lebih besar untuk mengalami stres dibandingkan dengan responden yang memiliki kecerdasan emosional tinggi